Attendees at a recent PURPOSE meeting

PURPOSE staff hosted researchers at the network's first meeting in May 2023. Photo credit: Neurovations Education, Inc.

For many decades, pain has been the main reason people seek health care. Yet such visits are brief and infrequent – and often patients go right back to everyday life without a clear plan for pain relief. One contributing factor is that many health care providers receive little specific education about pain management during their training. Until not long ago, pain was not considered a condition by itself, but rather a side effect or symptom of other health problems.

Another major problem is that we don’t have safe and effective treatments, especially for long-lasting pain. New cases of chronic pain in the United States now outnumber those of other common chronic diseases or health conditions, such as diabetes, depression, and high blood pressure. Undertreated pain affects millions of Americans, and the use of opioids to block pain contributes to the nation’s current overdose crisis. That’s even though there is no good evidence to support the use of opioid medications to treat low back pain or osteoarthritis, two of the most common chronic pain conditions among adults.

To meet this significant unmet medical need, the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, has built a comprehensive set of research programs to develop scientific solutions for effective pain management with non-addictive therapies. Part of this strategy is to connect pain scientists in HEAL and beyond to accelerate this complex process.

Building the Team

Thousands of HEAL researchers are working on various aspects of pain, and they come from different scientific backgrounds. Some are basic scientists focusing on understanding what causes pain, toward discovery and development of new, non-addictive medications by testing them in cell-based or animal models of pain. Some are pain psychologists and physical therapists testing complementary and integrative pain management strategies. Others are primary care physicians, nurses, rheumatologists, and anesthesiologists participating in real-world research in a range of clinical practice settings. Still others are engineers developing technologies to relieve pain and data scientists using cutting-edge methods to unlock secrets in diverse types of data: gene expression, nervous system function, brain and spinal cord imaging, patient surveys, clinical trial results, and more.

Several HEAL programs aim to increase the number of scientists studying pain management. For example, the HEAL PAIN Cohort Program aims to help early career pain researchers acquire experience from multiple perspectives that represent the many scientific disciplines relevant to pain research, including those that haven’t traditionally been included. Examples of these additional disciplines include engineering, behavioral health, anthropology, computer and data science, addiction medicine, and public health. Still other HEAL workforce strategies include a new program targeted to clinicians and scientists who want to focus on training and conducting clinical pain research. These researchers need “protected” time away from clinical responsibilities, which HEAL will fund for up to 3 years.

But as important to increasing the number of researchers is the need to connect them.

Basic scientists who study pain management typically work in their own labs on their own research questions. Clinical pain researchers usually collect biological and/or psychological data from human patients and conduct trials in hospitals (often associated with universities). Most of the time, these research pursuits work in parallel, on separate tracks. Basic scientists that explore molecules and cells don’t often have the opportunity or vocabulary to talk to clinical researchers – and vice versa. Yet those connections are absolutely critical for understanding the cause and consequences of complex human pain conditions, and for developing new ways to treat the complex human experience of pain.

“We really need a scientific marriage between basic and clinical scientists, says D.P. Mohapatra, Ph.D., Program Director for Pain at the National Institute of Neurological Disorders and Stroke (NINDS), who leads the oversight of several HEAL-funded basic and translational research programs, “and we need that marriage to last a long time.”

HEAL-funded pain scientists now have a way to exchange ideas, work together to answer complicated research questions, and learn from patients to ensure that research meets the needs of people who live with pain. The goal of this HEAL-funded network, called PURPOSE (Positively Uniting Researchers of Pain to Opine, Synthesize, & Engage) is to connect  researchers across the continuum of pain research, from all disciplines and at all career stages, and to expand the pain research workforce, explains Laura Dover Wandner, Ph.D., Program Director at NINDS who co-leads HEAL clinical workforce efforts and manages the PURPOSE program.

“Clinical trials and studies are getting harder to do, and a lot of people aren’t trained to do them,” Wandner says. “There’s a workforce shortage in part because there are a number of senior, experienced pain researchers who are retiring and leaving the field, which makes it harder to be able to train the next generation of researchers.”

Tackling Complexity

Despite the prevalence of pain, it remains poorly understood. But new technology, and the knowledge that can be acquired with its use, brings new opportunities to solve urgent problems related to pain management.

“Pain hasn’t gotten more complex,” says Jacob Coverstone, Managing Director for Neurovations Education in Napa, California, “but neither has the universe,” offering a comparison to astronomers who have state-of-the-art tools like new telescopes that allow them to see and understand space in amazing new ways. Similar breakthroughs have been made for biology, he explains, and now for pain, too.

Coverstone runs the daily operations of the PURPOSE Network. In an unusual but apt metaphor, he likens the need for a pain research network to the early days of the automobile industry. Internal combustion engines were the first breakthrough, he explains, but then someone needed to figure out how to connect the people who built engines with the window-makers and the tire-makers and all the other pieces – to make a functional car.

“What we need now for pain research is the equivalent of an automaker,” Coverstone says, to fit all the puzzle pieces together and make appropriate pain treatments available to patients.

PURPOSE offers collaborative online spaces for any pain researcher to similarly learn about ongoing research and new pain funding opportunities, and to find other scientists to collaborate with around a common research problem. Other resources include:

  • A centralized community for research trainees and researchers across the continuum of basic, translational, and clinical research
  • Ongoing webinars and training opportunities
  • Weekly network digests via email
  • Opportunities for multidisciplinary collaborations when developing grant applications
  • Information about job opportunities

“It’s really a great platform for any scientist who is studying pain: to learn, to connect with each other, and to learn about recent publications or upcoming funding opportunities or just things that are relevant for them,” says Nele Haelterman, Ph.D., of Baylor College of Medicine in Houston, Texas. She is part of the Restoring Joint Health and Function to Reduce Pain (RE-JOIN) consortium working to create 3D innervation maps of two joints frequently affected by pain: the knee and the jaw.

RE-JOIN research involves scientists from lots of different fields, involving many different types of projects, since the program is looking for new ways to understand and manipulate neuronal changes that contribute to joint pain. Most current technologies to study nerve patterns related to pain were developed for soft tissues like the brain and inner organs. Novel forms of expertise are needed to fill this gap and adopt them for use in joint-associated tissues.

PURPOSE has given the RE-JOIN team a one-stop shop to work together, Haelterman explains. Leading coordination of this large research team, she needed a centralized location to guide the consortium members: for onboarding, scheduling, storing files, and sharing research updates. But she sees additional value.

“By using the PURPOSE platform, I hope that early career researchers will figure out that they can find mentorship, career development opportunities (like the PURPOSE meeting), and even job opportunities,” she adds. “On the other hand, I hope that senior RE-JOIN investigators will come across the platform’s versatile options to find collaborators and funding opportunities.” 

Researchers learn from each other at the PURPOSE meeting in May 2023.

Pain researchers learn from each other at the PURPOSE meeting in May 2023. Photo credit: Neurovations Education, Inc.

Connecting Dots

“I’ve talked to basic scientists who say, ‘I know exactly what happens when you put your finger on a thumbtack – how the sensory input travels through the peripheral nervous system, and the signal ultimately reaches the brain’,” Coverstone explains, “‘but I have no idea how those molecular events translate to the unique experience of pain’.”

In May 2023, PURPOSE held its first meeting, in metropolitan Washington, D.C. In-person and virtual attendees heard from leaders in all aspects of pain research and had numerous opportunities to interact with each other. According to Coverstone, sessions were structured to offer career development and to encourage cross-learning. For example, discipline-specific sessions focused on specific topics like basic pain anatomy or pain psychology, and specialists were encouraged not to attend sessions where they already knew the subject matter.

The broad goal of the meeting – mirroring the mission of PURPOSE – was to “learn something new” by connecting with scientists who share common interests but have different expertise and training. PURPOSE thus joins the many HEAL research programs aiming to demystify pain in an effort to help patients who live with pain and improve their quality of life.

Explore the PURPOSE Network

Request to join the PURPOSE network, and join colleagues in sharing information about pain research.

Learn More


Learn about the role of the National Institute of Neurological Disorders and Stroke in the NIH HEAL Initiative.

Learn More

Sign Up to Receive HEAL Research News

Subscribe to the monthly HEAL Digest to receive NIH HEAL Initiative research advances in your inbox.

Subscribe Today