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

Inclusion Criteria: 1. Age 18 to 70 years 2. Ability to read and write English sufficiently to understand and complete study questionnaires 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 will be included if their acute pain complaint at ED presentation is not due to neuropathic pain 7. Individuals with a history of psychotic or bipolar disorder that is currently well managed, have been treated for the condition for at least 3 months, are able to coherently answer interview questions, and are judged by study staff to be capable of participating in study 8. Current chronic illness that involves constant or frequent pain if their acute pain complaint 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 ED presentation is not related to their current chronic pain. (case-by-case basis) Exclusion Criteria: 1. Pain intensity great enough to impair concentration or capacity to understand instructions or the nature of being invited into a study as assessed by a member of the medical staff 2. Any injury or illness that precludes their ability to understand or follow instructions as assessed by a member of the medical staff 3. Self-reported history of chronic pain on presentation to the ED or documented in the electronic 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 diseases such as rheumatoid disease, current influenza that may manifest temporary flu- related pain, and heart disease.