Burel R Goodin

• PhD
• Professor (Full) at Washington University in St. Louis

Introduction Fibromyalgia (FM) is a widespread chronic pain condition with prevalence increasing in older adults. Older adults living with FM experience longer pain symptom durations that can negatively impact their quality of life. Affect and neuroinflammation are potential factors that can exacerbate pain symptoms. Exercise is a recommended inter...

As people live longer with HIV, reports of poor sleep and neurocognitive impairments are expected to increase. Poor sleep and neurocognitive impairments commonly occur in people living with HIV (PLWH) and some medications (e.g., anticholinergics) contribute to these problems. The association between sleep and neurocognition among PLWH taking such m...

Introduction Factors contributing to individual differences in knee osteoarthritis remain elusive. Dispositional traits and socioeconomic status are independent predictors of mental and physical health, although significant variability remains. Dispositional traits serve as the biological interface for life experiences. Objectives We investigate g...

Background Knee osteoarthritis (KOA) is a prevalent chronic pain condition that can significantly impact quality of life and contribute to recognized chronic pain racial disparities. We have shown that a low-carbohydrate diet (LCD) can reduce KOA-related pain. Our previous work suggested that the LCD was more beneficial for women and non-Hispanic B...

Introduction Having a lower socioeconomic status (SES) is a predictor of age-related chronic conditions, including chronic low back pain (cLBP). We aimed to examine whether the pace of biological aging mediates the relationship between SES and cLBP outcomes – pain intensity, pain interference, and physical performance. Methods We used the Dunedin...

Objective The objective was to examine potential pathways linking neighborhood disadvantage to pain severity in individuals with knee pain consistent with or at risk for knee osteoarthritis (KOA). Methods The current investigation is a cross‐sectional analysis. Data were collected from 140 middle‐aged to older non‐Hispanic White and non‐Hispanic B...

Objective We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White U.S. adults with chronic low back pain. Methods Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the i...

Objective Lower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, whic...

Lower socioeconomic position (SEP) is associated with increased risk of developing chronic pain, experiencing more severe pain, and suffering greater pain-related disability. However, SEP is a multidimensional construct; there is a dearth of research on which SEP features are most strongly associated with high-impact chronic pain, the relative impo...

This study aimed to determine the nature of the relationship between the internalized stigma of chronic pain (ISCP), the pace of biological aging, and racial disparities in nonspecific chronic low back pain (CLBP). We used Dunedin Pace of Aging from the Epigenome (DunedinPACE), Horvath’s, Hannum’s, and PhenoAge clocks to determine the pace of biolo...

Chronic low back pain (cLBP) remains a major health crisis worldwide. Current conceptualizations of cLBP utilize the biopsychosocial model, yet research on social factors remains limited. Adverse childhood experiences (ACEs) are a risk factor for a variety of chronic health problems, including cLBP. However, the extent to which socioeconomic contex...

Introduction Global prevalence of knee osteoarthritis is more than 300 million. Uncontrollable risk factors include age, sex, and height. Controllable risk factors include trauma, weight, and waist circumference. Objectives Our goal was to determine the association between knee osteoarthritis and anthropometric measures that include weight, height...

Objectives: Insomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one s...

Social cognition—the complex mental ability to perceive social stimuli and negotiate the social environment—has emerged as an important cognitive ability needed for social functioning, everyday functioning, and quality of life. Deficits in social cognition have been well documented in those with severe mental illness including schizophrenia and dep...

Introduction Movement-evoked pain (MEP) impacts a substantial proportion of US adults living with chronic pain. Evidence suggests that MEP is influenced by numerous biopsychosocial factors and mediated by mechanisms differing from those of spontaneous pain. However, both characteristic and mechanistic knowledge of MEP remain limited, hindering effe...

The Global Task Force on Chronic Pain in HIV published seven research priorities in the field of HIV-associated chronic pain in 2019: (1) causes; (2) management; (3) treatment individualization and integration with addiction treatment; (4) mental and social health factors; (5) prevalence; (6) treatment cost effectiveness; and (7) prevention. The cu...

Existing literature has primarily focused on sex differences in pain perception in pain-free populations. However, no studies have used experimental pain testing in cisgender and transgender individuals to assess gender differences in pain processing. Transgender individuals are disproportionately affected by mental-health disparities, which may fu...

Traditionally, pain research has focused on binary sex assignments, as opposed to gender identity. Data from our ongoing study suggests that one’s gender identity may play a bigger role in the experience of pain than sex assigned at birth. In this study, we utilize quantitative sensory testing (QST) — a standardized method for quantifying an indivi...

Background The concordance between radiograph-derived Kellgren–Lawrence (KL) scores for knee osteoarthritis (KOA) and experimental and clinical pain and KOA-related physical function is conflicting. Objectives We investigate whether the inclusion of dispositional traits reduces variability between KOA radiographic findings, experimental pain, clin...

Chronic low back pain (cLBP) is a global health crisis that disproportionately burdens non-Hispanic Black (NHB) individuals, compared with those who identify as non-Hispanic White (NHW). Despite the growing personal and societal impact of cLBP, its biological underpinnings remain poorly understood. To elucidate the biological factors that underlie...

Chronic obstructive pulmonary disease (COPD) is a fatal chronic disease experienced by 10% of people living with HIV (PLWH). As the population of older PLWH continues to increase, the prevalence of COPD is anticipated to grow as well. Despite this concerning trend, there is a lack of theoretical models to guide clinical practice and research on agi...

Introduction Prior research suggests that African Americans (AAs) have more frequent, intense, and debilitating pain and functional disability compared with non-Hispanic Whites (NHWs). Potential contributing factors to this disparity are physical activity and sedentary behavior, given that AAs are less physically active, and physical activity is as...

Objective Chronic musculoskeletal pain is associated with neurobiological, physiological, and cellular measures. Importantly, we have previously demonstrated that a biobehavioral and psychosocial resilience index appears to have a protective relationship on the same biomarkers. Less is known regarding the relationships between chronic musculoskelet...

Chronic knee pain is a common condition that often co-occurs with insomnia. Epigenetic modifications, such as DNA methylation, may play a role in the sleep-pain relationship. In this study, we aimed to identify differentially methylated CpGs/regions and enriched genomic pathways associated with insomnia in participants with knee pain (KP). We recru...

Introduction: Previous research indicates ethnic/race group differences in pain and neurodegenerative diseases. Accounting for socioenvironmental factors reduces ethnic/race group differences in clinical and experimental pain. In the current study sample, we previously reported that in individuals with knee pain, ethnic/race group differences were...

The present study sought to leverage machine learning approaches to determine whether social determinants of health improve prediction of incident cardiovascular disease (CVD). Participants in the Jackson Heart study with no history of CVD at baseline were followed over a 10-year period to determine first CVD events (i.e., coronary heart disease, s...

Background Interest in how the neighborhood environment impacts age-related health conditions has been increasing for decades. Epigenetic changes are environmentally derived modifications to the genome that alter the way genes function—thus altering health status. Epigenetic age, a biomarker for biological age, has been shown to be a useful predict...

Chronic musculoskeletal pain is a leading cause of disability worldwide. Previous research indicates ethnic/race groups are disproportionately affected by chronic pain conditions. However, when considering socioenvironmental factors these disparities are no longer observed. Ethnic/race group differences have also been reported in pain-related brain...

Mild to moderate forms of neurocognitive impairment persist among people living with HIV (PLWH), despite being virally suppressed on antiretroviral therapy. PLWH are disproportionally impacted by physiological and psychosocial comorbidities compared to those without HIV. As adults live longer with HIV, the neurocognitive burden of physiological and...

African Americans are disproportionately exposed to adversity across the lifespan, which includes both stressful and traumatic events. Adversity, in turn, is associated with alterations in pain responsiveness. Racial differences in pain responsiveness among healthy adults are well established. However, the extent to which adversity type and timing...

Background: Physical stressors can cause a physiological response that can contribute to an increase in mitochondrial dysfunction and mtDNA damage. People living with HIV (PWH) are more likely to suffer from chronic pain and may be more susceptible to mitochondrial dysfunction following exposure to a stressor. We used Quantitative Sensory Testing...

Objective: Many children with chronic musculoskeletal pain conditions experience stigma which can have negative downstream consequences. This study compares ratings of clinical pain (current pain intensity and pain interference), experimental pain (temporal summation, cold water tolerance, and cold pain intensity), and pain-related stigma among th...

Knee pain, the most common cause of musculoskeletal pain (MSK), constitutes a severe public health burden. Its neurobiological causes, however, remain poorly understood. Among many possible causes, it has been proposed that sleep problems could lead to an increase in chronic pain symptomatology, which may be driven by central nervous system changes...

An estimated 250 million people worldwide suffer from knee osteoarthritis (KOA), with older adults having greater risk. Like other age-related diseases, residents of high-deprivation neighborhoods experience worse KOA pain outcomes compared to their more affluent neighbors. The purpose of this study was to examine the relationship between neighborh...

Chronic widespread pain (CWP) is associated with a high rate of disability and decreased quality of life in people with HIV-1 (PWH). We previously showed that PWH with CWP have increased hemolysis and elevated plasma levels of cell-free heme, which correlate with low endogenous opioid levels in leukocytes. Further, we demonstrated that cell-free he...

An overwhelming number of people with HIV (PWH) experience chronic widespread pain (CWP) throughout their lifetimes. Previously, we demonstrated that PWH with CWP have increased hemolysis and attenuated heme oxygenase 1 (HO-1) levels. HO-1 degrades reactive, cell-free heme into antioxidants like biliverdin and carbon monoxide (CO). We found that hi...

Background: Prolonged postoperative opioid use (PPOU) is considered an unfavorable post-surgical outcome. Demographic, clinical, and psychosocial factors have been associated with PPOU, but methods to prospectively identify patients at increased risk are lacking. Objectives: Our objective was to determine whether an individual or a combination o...

Background and purpose We and others have reported ethnic/race group differences in clinical pain, physical function, and experimental pain sensitivity. However, recent research indicates that with consideration for socioenvironmental factors, ethnicity/race differences become less or non-significant. Understanding of factors contributing to pain i...

Patients with advanced cancer are commonly prescribed opioids, yet patient attitudes about opioid risks (e.g., opioid use disorder, or OUD) are understudied. Our objective was to use in-depth qualitative interviews to understand perceptions of opioid prescribing and OUD in patients with advanced, solid-tumor cancers and their support people. We con...

Persistent fatigue is often reported in those with chronic musculoskeletal pain. Separately, both chronic pain and chronic fatigue contribute to physical and cognitive decline in older adults. Concurrent pain and fatigue symptoms may increase disability and diminish quality of life, though little data exist to show this. The purpose of this study w...

Background The pathoanatomic cause of chronic low back pain (cLBP) cannot be identified for up to 90% of individuals. However, dysfunctional processing of endogenous nociceptive input, measured as conditioned pain modulation (CPM), has been associated with cLBP and may involve changes in neuronal gene expression. Epigenetic-induced changes such as...

Non-specific chronic low back pain (cLBP) represents a common musculoskeletal condition with no identifiable cause. It cannot be diagnosed with conventional neuroimaging techniques such as computerized tomography (CT). The diagnostic uncertainty that characterizes non-specific cLBP can lead to stigmatizing responses from others that can become inte...

Purpose of Review Antiretroviral therapy has significantly reduced morbidity and mortality in people with HIV. Despite being virally suppressed, sleep disturbances, chronic pain, and neurocognitive impairments persist which can negatively impact quality of life for people with HIV. This article presents relevant literature related to sleep disturba...

The tendency to ruminate, magnify, and experience helplessness in the face of pain — known as pain catastrophizing — is a strong predictor of pain outcomes and is associated with adversity. The ability to maintain functioning despite adversity — referred to as resilience — also influences pain outcomes. Understanding the extent to which pain catast...

Sleep disorders are prevalent among college students and are associated with poor academic performance. Few studies have included a clinical interview to comprehensively assess sleep disorder diagnostic criteria or assessed academic functioning (e.g., class attendance). College students (n = 277) were recruited to complete sleep questionnaires, a s...

One clinically useful collection of tools for measuring the pain experiences of patients with chronic pain conditions is referred to as quantitative sensory testing (QST). QST includes an array of non-invasive procedures that quantify human pain perception during the administration of standardized noxious stimuli with predetermined physical propert...

Disability prevention and preservation of independence is crucial for successful aging of older adults. To date, relatively little is known regarding disparities in independent aging in a disadvantaged older adult population despite widely recognized health disparities reported in other populations and disciplines. In the U.S., the Southeastern reg...

Extant literature posits that humans experience two types of threat: physical threat and social threat. While describing pain as “physical” or “social” can be helpful for understanding pain origins (i.e., broken bone versus lost relationship), this dichotomy is largely artificial and not particularly helpful for understanding how the human brain ex...

PURPOSE Stigma surrounding prescription opioids, or opioid stigma, is increasingly recognized as a barrier to effective and guideline-concordant cancer pain management. Patients with advanced cancer report high rates of pain and prescription opioid exposure, yet little is known about how opioid stigma may manifest in this population. METHODS We co...

Emerging literature suggests that non-specific chronic low back pain (cLBP) is linked with elevated serum levels of pro-inflammatory biomarkers. Additionally, evidence suggests that socioeconomic status may also have an impact on levels of inflammation, specifically at the neighborhood level. However, there is little information about how levels of...

People with HIV (PWH) appear to be at high risk for the experience of recurring pain symptoms throughout their lifetimes. There is also evidence to suggest a high prevalence of insomnia and sleep difficulties in PWH. Insomnia may lead to exaggerated pain states in PWH such as hyperalgesia, which refers to the phenomenon of heightened sensitivity to...

Emerging literature suggests that experiences of discrimination negatively influence health and well-being. It is unfortunately common for people living with HIV (PLWH) to be stigmatized and discriminated against because of their HIV status and other marginalized identities (e.g., ethnicity/race, sexual identity and orientation). To date, little re...

Findings from a multi-site study conducted by our research team previously revealed that non-Hispanic Black (NHB) adults with high chronic pain stage have thinner temporal cortex relative to their non-Hispanic White (NHW) counterparts with knee pain. Groups differ on a number of neurobiologically relevant socio/environmental factors. Mounting evide...

Prolonged postoperative opioid use (PPOU) is considered an unfavorable post-surgical outcome. Demographic, clinical, and psychosocial factors have been associated with PPOU, but methods to prospectively identify patients at increased risk are lacking. We sought to determine whether individual or a combination of several psychological factors could...

Knee osteoarthritis (OA) is a common progressive joint disease with increasing prevalence. There are inconsistent findings on the concordance between radiograph derived Kellgren-Lawrence (KL) scores and pain measures. We have previously reported that dispositional traits predict sensory sensitivity and psychosocial functioning. This study aims to d...

Chronic low back pain (cLBP) is the second leading cause of disability in the United States, and disproportionately burdens Non-Hispanic Black (NHB) individuals compared to Non-Hispanic White (NHW) individuals. However, its biological underpinnings are poorly understood. The aim of this study was to investigate differences in basal inflammatory cyt...

Chronic low back pain (cLBP) is one of the leading causes of pain for millions of Americans. Recent growing literature suggests that individuals with cLBP may have elevated symptoms of depression. Optimism and pessimism are aspects of human personality related to generalized outcome expectancies for the future. Both are also associated with physica...

Individuals with painful knee osteoarthritis (OA) frequently report poor sleep quality. Neighborhood disadvantage has been shown to be associated with poor sleep quality and detriments to physical health outcomes. The overall aim of this study was to elucidate further the relationships among neighborhood disadvantage, physical function, and sleep q...

Considerable evidence demonstrates that radiographic findings (e.g., osteophytes) are only modestly associated with the severity of knee pain, suggesting that other biopsychosocial factors likely influence symptom severity. Multiple psychological factors have been linked to worse health outcomes in people with chronic knee pain; however, it remains...

Chronic pain contributes to allostatic load (AL). Individuals with protective psychosocial and biobehavioral factors report lower levels of clinical pain. We have previously shown a relationship between a resilience index, telomere length, and brain structure. This study aims to assess the relationships between AL, a resilience index, and clinical...

Chronic low back pain (CLBP) is one of the leading causes of pain and disability in adults in the United States and disproportionately burdens non-Hispanic Black (NHB) individuals and females. Approximately 90% of CLBP cases are of unknown cause, and it is imperative that potential causes be explored. It has been reported that diet quality can infl...

Background: Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, r...

Chronic pain is a significant public health problem, and the prevalence and societal impact continues to worsen annually. Multiple cognitive and emotional factors are known to modulate pain, including pain catastrophizing, which contributes to pain facilitation and is associated with altered resting-state functional connectivity in pain-related cor...

Compared to Non-Hispanic Whites (NHWs), individuals who self-identify as Non-Hispanic Blacks (NHBs) in the United States experience more severe and disabling chronic low back pain (cLBP). We hypothesized that differences in DNA methylation (DNAm) play a role in racial disparities in cLBP. Purpose: To determine the relationship between DNAm levels...

Racism is an established health determinant across the world. In this 3-part series, we argue that a disregard of how racism manifests in pain research practices perpetuates pain inequities and slows the progression of the field. Our goal in part-1 is to provide a historical and theoretical background of racism as a foundation for understanding how...

This third paper in the “Confronting Racism in All Forms of Pain Research” series discusses adopting an antiracism framework across all pain research disciplines and highlights the significant benefits of doing so. We build upon the previous call to action and the proposed reframing of study designs articulated in the other papers in the series and...

This second paper in a three-part series on antiracism in pain research across the translational spectrum focuses on study design factors. Although objectivity is a cornerstone value of science, subjectivity is embedded in every step of the research process as investigators make choices about who they collaborate with, which research questions they...

Chronic low back pain (cLBP) is the most common reason for individual suffering and health care utilization in adults. Ample evidence suggests sociodemographic variables and socioeconomic status (SES) influence pain. However, a framework informing associations on race, SES, and the utilization of pharmacologic therapies and provider type are limite...

Introduction Considerable evidence suggests that there are significant ethnic/racial differences in the experience of pain among individuals suffering from chronic musculoskeletal conditions. Additionally, low levels of vitamin D have been associated with pain severity. Further, vitamin D deficiency is more prevalent in Non-Hispanic Black (NHB) ind...

Background: Racial disparities in trauma care have been reported for a range of outcomes, but the extent to which these remain after accounting for socioeconomic and environmental factors remains unclear. The objective of this study was to evaluate the unique contributions of race, health insurance, community distress, and rurality/urbanicity on t...

Dispositional traits can be protective or contribute to increased vulnerability in individuals with chronic pain. This study aims to evaluate the association between two dispositional trait measures, affect balance style and multi-domain trait groups, with psychosocial measures, clinical pain, functional pain, and experimental pain at two years in...

Objective Knee osteoarthritis (OA) is a leading source of pain and disability among older adults. Self‐management (SM) strategies are recommended to manage OA symptoms. Sociodemographic and clinical characteristics, along with other factors, may influence SM utilization rate. This study sought to examine the prevalence and correlates of SM use for...

Background and Purpose How the Area Deprivation Index (ADI) performs compared to other measures of socioeconomic status (SES) is unknown. The study purpose is to compare the ADI and other measures of SES in their ability to predict pain severity/interference. Methods Four measures of SES were compared—ADI, income, education, and subjective social...

Compelling evidence exists that non-Hispanic blacks (NHB) engage in pain catastrophizing (negatively evaluate one’s ability to cope with pain) more often than non-Hispanic whites (NHW). Functional neuroimaging studies revealed that individuals with high levels of trait pain catastrophizing show increased cerebral responses to pain in several pain-r...