Preventing the Development of Chronic Pain: Treating PTSD at Acute Pain Onset

Last updated: October 17, 2025
Sponsor: Rush University Medical Center
Overall Status: Active - Recruiting

Phase

N/A

Condition

Chronic Pain

Post-traumatic Stress Disorders

Pain

Treatment

Cognitive Processing Therapy

Stellate Ganglion Block

Clinical Study ID

NCT05700279
21092002
  • Ages 18-70
  • All Genders

Study Summary

Although most people recover from acute pain (such as pain caused by injury, surgery, repetitive motion, or unknown causes), many people do not fully recover and will experience chronic pain. Untreated posttraumatic stress disorder (PTSD) appears to be a key risk factor for the transition from acute pain to chronic pain. However, few published studies have addressed the issue of preventing the transition from acute to chronic pain via PTSD reduction. This project will aim to test whether trauma-related PTSD symptoms can be reduced using either Stellate Ganglion Block (SGB) treatment or Cognitive Processing Therapy (CPT), and whether reducing PTSD symptoms can prevent the transition from non-injury based acute pain to chronic pain.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Age 18 to 70 years

  2. Ability to read and write English sufficiently to understand and complete studyquestionnaires and participate in interviews

  3. Presenting to the Rush ED with acute pain without debilitating trauma

  4. A primary acute pain site

  5. Self-reported symptoms consistent with a diagnosis of PTSD

  6. People with well-controlled diabetes or HIV/AIDS with chronic neuropathic pain willbe included if their acute pain complaint at ED presentation is not due toneuropathic pain

  7. Individuals with a history of psychotic or bipolar disorder that is currently wellmanaged, have been treated for the condition for at least 3 months, are able tocoherently answer interview questions, and are judged by study staff to be capableof participating in study

  8. Current chronic illness that involves constant or frequent pain if their acute paincomplaint at ED presentation is not due to the chronic illness. (case-by-case basis)

  9. Current chronic pain from various sources if their acute pain complaint at EDpresentation is not related to their current chronic pain. (case-by-case basis)

Exclusion

Exclusion Criteria:

  1. Pain intensity great enough to impair concentration or capacity to understandinstructions or the nature of being invited into a study as assessed by a member ofthe medical staff

  2. Any injury or illness that precludes their ability to understand or followinstructions as assessed by a member of the medical staff

  3. Self-reported history of chronic pain on presentation to the ED or documented in theelectronic medical record (case-by-case basis)

  4. Pain from traumatic event that is the source of their PTSD

  5. Neurological disorder

  6. Blood pressure greater than 160/100 mmHg

  7. Taking anticoagulants or antiplatelet drugs other than aspirin

  8. Pregnancy

  9. Current alcohol or substance dependence

  10. Anything that precludes interventions from being successful.

  11. We will exclude people who are being treated for chronic or significant diseasessuch as rheumatoid disease, current influenza that may manifest temporary flu-related pain, and heart disease.

Study Design

Total Participants: 345
Treatment Group(s): 2
Primary Treatment: Cognitive Processing Therapy
Phase:
Study Start date:
September 01, 2023
Estimated Completion Date:
February 01, 2027

Study Description

Untreated PTSD appears to be a key risk factor for the transition from acute pain to chronic pain. Thus, reducing PTSD symptoms during an acute pain episode may potentially decrease the likelihood of transitioning to chronic pain. CPT is an evidence-based trauma-focused cognitive behavioral treatment that is hypothesized to reduce PTSD symptoms via reducing negative trauma-related cognitions about oneself, others, and the world. SGB treatment is an injection of a local anesthetic into the stellate ganglion, which is a bundle of nerves located at the base of the neck that is part of the sympathetic nervous system. Previous studies suggest that 1-week massed CPT and SGB treatment can both reduce the severity of PTSD symptoms in short periods of time via two distinct psychological and biological mechanisms.

This 4 year project will test study hypotheses in a sample of 345 individuals with PTSD symptoms who present to the presenting to the Rush University Medical Center ED or Rush's Primary Care and Preventive Medicine group with non-injury based acute pain. Participants will be randomly assigned to receive 1-week massed CPT, 2 SGB treatments, or usual care. All participants will complete identical self-report and/or clinician administered assessments at baseline (prior to randomization) and on study days 1, 7, 14, 21, 28, 56 (approximately 3 months after the initial ED presentation or Presentation to Preventive Medicine), and 112 (approximately 6 months after ED presentation or presentation to Preventive Medicine).

Connect with a study center

  • Rush University Medical Center

    Chicago, Illinois 60612
    United States

    Site Not Available

  • Rush University Medical Center

    Chicago 4887398, Illinois 4896861 60612
    United States

    Active - Recruiting

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