Military researcher searches for solutions to chronic pain epidemic

Josh Van Wyngaarden, PT, DPT, has always been interested in the mechanisms behind pain. As a member of the U.S. Air Force, he’s well-acquainted with chronic pain and the devastating effect it can have on his fellow Airmens’ lives. 

“One of my more challenging stints was at the Center for the Intrepid in San Antonio,” he said. “It’s a rehabilitation facility where most of our military wounded warriors receive treatment after a blast-related injury experienced during deployment. Chronic pain and suffering were such a huge problem in that population. I also experienced this in day-to-day clinical care; despite evidence based treatment, many patients would go on to develop chronic pain. I knew then we needed to find better ways to figure out who’s at risk for a bad outcome.’”

So, when the opportunity came to pursue a PhD and accompanying research, Josh leapt at the chance. He is now working on his doctorate in the rehabilitation sciences PhD program at the College of Health Sciences (CHS) as part of Dr. Brian Noehren’s Biomotion Lab.

Josh was on deployment in South Korea when the call for applications was released and he found out shortly after he applied that he’d been selected to CHS’s program. The rest is history. Dr. Noehren and Josh began skyping regularly to solidify the direction of their research as he finished out his deployment.

“That strengthened my impression of him being a great mentor to work with,” Josh recalled. “Dr. Noehren was willing to narrow down the research ideas even before I started here so that when I arrived, we could hit the ground running.”

Now, nearly a year since his arrival here at UK, Josh is working to develop improved methods for identifying chronic pain risk factors. “We can use these methods to identify risk factors to create intervention platforms,” he said. “So right now, we’re laying the groundwork in order to identify patients who are most at risk for developing chronic pain.”

Since his research takes a more preventative stance towards chronic pain, it is likely to have implications for the fight to end Kentucky’s opioid epidemic. “We knew that chronic pain correlates highly with opioid use, but these intervention platforms can be developed to reduce that dependency on opioids,” Josh added. “We could help treat a patients’ pain without additional supplements of medication.”

Josh and his research team administer a number of surveys that aim to establish a basic understanding of patients’ overall mental health, including their self-efficacy, pain catastrophizing, and fear of movement in terms of their recovery. “So far we’re able to reliably predict who’s at risk for chronic pain at six months,” he said. “We’re trying to find ways to develop one-year outcomes, but we just don’t have enough of that data to speak to yet.”

Today, chronic pain costs about $635 billion a year between lost wages and medical expenditure. With limited treatment for chronic pain, preventative medicine seems to be the far better alternative to largely inefficient reactive medicine.

“If we can identify those risk factors to get the right people to the right treatment at the right time, then we can hopefully decrease the number of people that develop chronic pain. That cost is about more than just money,” Josh said. “It’s also the suffering, and the loss in quality of life.”

Josh is excited about the potential outcomes of this project. “If I have good results based off of this, it will open up a lot of opportunities for intervention,” he continued. “I’d also like to apply some of this work we’re doing with the lower-extremity trauma population to back pain and other body regions.”

To others considering graduate research, Josh advises being ready for the grind. “None of this is easy work,” he said. “I would start by shadowing someone to make sure research is something you’re truly interested in. There are so many opportunities especially in the Biomotion Lab. We open it up for undergrads and they can get a ton of research experience. That’s a really cool way to get plugged in and figure out if research is for you.”