110 Participants Needed

Pain Reprocessing Therapy for Chronic Knee Pain

(REJOICE Trial)

Recruiting at 1 trial location
AN
Overseen ByAllina Nocon, PhD
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: University of Colorado, Denver
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Pain Reprocessing Therapy for chronic knee pain?

Pain Reprocessing Therapy (PRT) has shown effectiveness in treating chronic back pain, with two-thirds of patients reporting significant pain relief. This suggests that PRT, which focuses on changing how patients perceive and react to pain, could potentially be beneficial for chronic knee pain as well.12345

Is Pain Reprocessing Therapy safe for treating chronic knee pain?

There is no specific safety data available for Pain Reprocessing Therapy in the provided research articles. However, one study mentions that home-based exercise therapy for knee pain is considered safe and effective, which suggests that non-invasive treatments like Pain Reprocessing Therapy may also be safe.678910

How is Pain Reprocessing Therapy different from other treatments for chronic knee pain?

Pain Reprocessing Therapy (PRT) is unique because it focuses on changing how patients perceive and react to pain, rather than just addressing physical symptoms. It involves reappraising pain to reduce fear, understanding the connection between pain, emotions, and stress, and building supportive relationships with therapists and peers, which can lead to significant pain relief.111121314

What is the purpose of this trial?

The goal of this clinical trial is to learn whether Pain Reprocessing Therapy (PRT) can help adults with knee pain after knee replacement surgery. The study is comparing PRT to usual care (the regular treatment people get after surgery) to see which works better for relieving pain.The main questions the study aims to answer are:1. Does PRT help lower pain in people who have chronic knee pain after knee surgery?2. How do the effects of PRT compare with usual care in terms of pain relief and other factors such as anxiety, depression, and sleep?3. How does PRT impact the brain?Participants will:1. Be randomly assigned to receive either PRT or usual care.2. Complete questionnaires about their pain and health.3. If in the PRT group, have eight weekly therapy sessions over video calls with a therapist.4. If interested, may also take part in an optional EEG test to measure brain activity related to pain.

Eligibility Criteria

This trial is for adults with chronic knee pain after knee replacement surgery. Participants will be randomly assigned to receive either Pain Reprocessing Therapy (PRT) or usual post-surgery care and must be willing to complete questionnaires and possibly undergo an EEG test.

Inclusion Criteria

I had knee replacement surgery 3 months ago without issues and still have significant pain.

Exclusion Criteria

Active, current psychosis or mania
Active, current substance abuse, or problems with substance abuse within the past 2 years
I had chronic pain before surgery but not after 3 months post-op.
See 11 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Pain Reprocessing Therapy (PRT) or usual care for knee pain management

8 weeks
8 visits (virtual) for PRT group

Follow-up

Participants are monitored for pain intensity, opioid use, and psychological outcomes

26 weeks

Treatment Details

Interventions

  • Pain Reprocessing Therapy
Trial Overview The study aims to determine if PRT can reduce chronic knee pain more effectively than the usual care following knee surgery. It involves eight weekly therapy sessions via video calls and measures outcomes like pain relief, anxiety, depression, sleep quality, and brain activity related to pain.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Usual CareExperimental Treatment1 Intervention
Participants will be asked to continue whatever they are already doing to care for their knee pain. Length of the usual care condition will be eight weeks, the expected completion time of the PRT arm.
Group II: Pain reprocessing therapy (PRT)Experimental Treatment1 Intervention
PRT has five components: 1) education about the origin of pain in the brain, its reversibility, and the pain-fear cycle; 2) reinforcing education using personal biography; 3) "somatic tracking" of pain through mindfulness and reappraisal of pain sensations as non-dangerous; 4) lowering the level of personal threat that may trigger pain sensation; and 5) inducing positive affect in periods of pain. Patients will attend eight 50-minute, therapist-led sessions. Pacing will be weekly, for approximately eight weeks.Treatment will be provided by experienced PRT clinicians. All PRT sessions will be remotely delivered.

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials
1,842
Recruited
3,028,000+

Weill Medical College of Cornell University

Collaborator

Trials
1,103
Recruited
1,157,000+

Hospital for Special Surgery, New York

Collaborator

Trials
257
Recruited
61,800+

Findings from Research

In a randomized controlled trial, two-thirds of participants receiving pain reprocessing therapy (PRT) reported significant relief from chronic back pain, suggesting its efficacy as a novel psychological treatment.
Qualitative interviews with 32 adults revealed that participants attributed their pain relief to mechanisms such as reappraising pain to reduce fear, understanding the emotional connections to pain, and building strong social connections with therapists and peers.
"I don't have chronic back pain anymore": Patient Experiences in Pain Reprocessing Therapy for Chronic Back Pain.Tankha, H., Lumley, MA., Gordon, A., et al.[2023]

References

"I don't have chronic back pain anymore": Patient Experiences in Pain Reprocessing Therapy for Chronic Back Pain. [2023]
How to assess a new patient for a multidisciplinary chronic pain rehabilitation program: a review article. [2021]
Assessing benefits of the pain center: why some patients regress. [2021]
Long-term follow-up of patients with chronic musculoskeletal pain attending interdisciplinary pain rehabilitation: outcomes and predictive factors. [2021]
The Relationship Between Pain Catastrophizing and Outcomes of a 3-Week Comprehensive Pain Rehabilitation Program. [2018]
[Impact of the ''Enhanced Recovery After Surgery'' program in knee arthroplasty at the institutional level]. [2023]
Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference. [2020]
Management of neuropathic pain after knee surgery. [2020]
The influence of the analgesic model on postoperative pain in major knee surgery. [2013]
Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial. [2020]
Peripheral nerve stimulation for chronic knee pain following total knee arthroplasty: a systematic review. [2023]
Conservative management of MRI-confirmed knee osteoarthritis with instrument-assisted soft-tissue mobilization, joint manipulation, and platelet-rich plasma. [2022]
[Knee joint pain with signs of arthrosis]. [2018]
14.United Statespubmed.ncbi.nlm.nih.gov
Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain: A Randomized Trial. [2022]
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