Psychological Options for Wellness and Recovery (POWeR) for Veterans with Chronic Back or Neck Pain
Pain Reprocessing Therapy for Veterans With Chronic Back Pain: Comparative Efficacy and Facilitators and Barriers to Implementation
NA · University of Colorado, Denver · NCT07137715
This study tests whether Pain Reprocessing Therapy (PRT), cognitive behavioral therapy (CBT), or usual care works best to lower pain in veterans with chronic back or neck pain.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 360 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | University of Colorado, Denver (other) |
| Locations | 1 site (Aurora, Colorado) |
| Trial ID | NCT07137715 on ClinicalTrials.gov |
What this trial studies
In this randomized interventional trial, veterans with chronic neck or back pain are assigned to one of three groups: PRT, CBT, or usual care. Participants complete standardized questionnaires on pain intensity, emotional functioning, quality of life, anxiety, and pain medication use at baseline and follow‑up visits. Those assigned to PRT or CBT receive nine weekly therapy sessions delivered by video with trained therapists, while the usual care group continues their regular medical care. Outcomes compare pain reduction and secondary measures to see whether PRT provides larger or faster pain relief than CBT or usual care.
Who should consider this trial
Good fit: Veterans aged 18 or older with chronic neck or back pain present at least half the days over the past six months and average pain ≥4/10 are the intended participants.
Not a fit: Patients whose pain is likely due to peripheral or structural causes (for example predominant radiculopathy/sciatica, recent spine surgery or recent trauma, inflammatory or malignant causes) or who meet other medical exclusion criteria are unlikely to benefit from the psychological treatments tested.
Why it matters
Potential benefit: If successful, PRT could substantially reduce or eliminate chronic back or neck pain and improve functioning and quality of life for veterans, potentially lowering reliance on pain medications.
How similar studies have performed: CBT has shown modest benefits (~1–1.5 point pain reduction on an 11‑point scale), while a prior randomized trial of PRT (N=151) reported that 66% of PRT participants were pain‑free or nearly pain‑free at post‑treatment versus fewer than 20% in control groups.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults (18 and older) * Be veterans * Have a history of chronic back or neck pain defined as pain at least half the days of the last 6 months. * Have moderate or greater pain, defined as pain intensity ≥4 in the past week Exclusion Criteria: Clinical presentation suggestive of back pain that is secondary or peripheral in nature, including self-reported leg pain that is worse than back pain (indicative of radiculopathy or sciatica), spine surgery within the past 6 months, fall, motor vehicle accident or other trauma related to back pain in the past 6 months, back pain due to an inflammatory disorder, infection, or malignant etiology as determined per medical provider review, known sensory abnormality in trunk or legs, recent large (\>20 lbs) unexplained weight loss, difficulty controlling bowels (to screen out cauda equina syndrome), and self-reported diagnoses of specific inflammatory disorders (rheumatoid arthritis, polymyalgia rheumatica, scleroderma, Lupus, and polymyositis). Additionally, patients who meet any of the following criteria are ineligible due to anticipated difficulties complying with study procedures: * Moderate or severe cognitive impairment * Unstable or severe untreated mental health condition, including active suicidal ideation * Unstable or end-stage medical disease including active cancer * Back surgery planned within the next 6 months * Inability to communicate by telephone or video, including inability due to housing instability * Current pain-related litigation outside the VA (service connection-related applications are not excluded) * Having engaged in CBT or PRT for chronic pain in the past 6 months * Participants may be excluded based on the discretion of PIs Ashar and Frank
Where this trial is running
Aurora, Colorado
- VA Eastern Colorado Health Care System — Aurora, Colorado, United States (RECRUITING)
Study contacts
- Principal investigator: Jonathan K. Ashar, PhD — University of Colorado, Denver
- Study coordinator: Jonathan K Ashar, PhD
- Email: yoni.ashar.@cuanschutz.edu
- Phone: 303.724.2536
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Chronic Pain, Back Pain, Back Pain Lower Back Chronic, Neck Pain, Pain Reprocessing Therapy, PRT, Veterans, Cognitive Behavioral Therapy