Treating chronic pelvic pain without drugs is focus of $3.3 million NIH award

A UB expert on the behavioral treatment of chronic pain disorders has been awarded $3.3 million from the National Institutes of Health to conduct a five-year clinical study of drug-free behavioral treatments for chronic pelvic pain in men and women.

Jeffrey M. Lackner, chief of the Division of Behavioral Medicine, Jacobs School of Medicine and Biomedical Sciences, and an internationally recognized authority on chronic pain disorders, is principal investigator on the Easing Pelvic Pain Interventions Clinical Research Program study (EPPIC).

Chronic pelvic pain encompasses several common, debilitating conditions including interstitial cystitis/bladder pain syndrome in both males and females, and chronic prostatitis/chronic pelvic pain syndrome in males. The symptoms, persistent pelvic pain, pressure or discomfort, frequent urination and urge to urinate, affect millions of Americans.

“There is no adequate medical treatment for this cluster of painful urological disorders, and while behavioral treatments are recognized as a first-line treatment by the American Urological Association, we don’t really know which strategy works most effectively,” says Lackner, a faculty member in the Department of Medicine who sees patients through UBMD Internal Medicine. “We want to understand why the specific treatments work and which patients are most likely to get the most out of them.”

A total of 240 participants ages 18-70 will be recruited to study one of two behavioral self-management treatments with minimal clinician oversight or education/support.

“Too many pelvic pain patients want to feel better but don’t know how when medical therapies fall short,” Lackner says. “We hope to learn how a low-intensity, symptom self-management treatment can relieve more severe symptoms of chronic pelvic pain refractory to medical therapies.”

The study is being conducted in UB’s Behavioral Medicine Division in collaboration with an interdisciplinary team including Teresa L. Danforth, clinical associate professor in the Department of Urology and a physician with UBMD Urology; Tova S. Ablove, clinical associate professor in the Department of Obstetrics and Gynecology and a physician with UBMD Obstetrics and Gynecology; and colleagues from the University of Michigan, the University of California, Los Angeles, and New York University.

Because there is no medical cure for chronic pelvic pain, the goal of the trial is to assess the short- and longer-term benefits of two non-drug behavioral treatments to determine why they work and which patients are most likely to benefit.

“Without proper treatment, the symptoms of chronic pelvic pain can be isolating, disabling and frustrating,” Lackner says, “and because they are so unpredictable, symptoms can have a significant impact on the ability to work, carry out daily activities and live the kind of life patients want, making it a very real public health issue.”

The EPPIC study emphasizes home-based treatments, which, Lackner notes, makes them more available and accessible in a COVID world.

“This project exemplifies cutting-edge research, harnessing the talents of interdisciplinary research at UB to create convenient, effective, safe, partnered patient-centered care using innovative delivery models that bring relief to patients’ most troublesome pain symptoms resistant to medical therapies,” says Allison Brashear, vice president for health sciences and dean of the Jacobs School.

Recruitment is scheduled to begin later this spring. More information can be found at the study’s website.