No Pain – Our Gain

Dr. Josh Little’s quest to help those suffering from chronic pain

By Christine Temple 1”3

In a laboratory on the campus of the Saint Louis University School of Medicine, Dr. Josh Little and his team of student researchers study the causes and potential treatments for chronic pain. And at the heart of their work is a desire to help those who suffer.

That takes on a personal meaning for Little.

As a child, his father’s ongoing illnesses and surgeries put him in chronic pain. It wasn’t until Little was older that the impact of that experience was fully realized.

“I remember that being a child, you really want to be able to play with your dad and interact…I wasn’t able to oftentimes because he wasn’t able to manage his pain well enough,” Little said.

“I remember that being pretty devastating, but then as I got older, I was thinking this must be really difficult for my father to deal with on a daily basis and how he could function with pain constantly being a part of his existence.”

That’s when his passion to help people, like his father, began.


Chronic pain affects millions of people and costs billions of dollars every year. Little is hopeful the research done in his lab will discover new approaches to pain treatment.

Little graduated from Evangel University with a degree in Physical Education and completed his pre-professional studies in 2002. He went on to study at the National University of Health Sciences in Illinois where he earned a B.S. degree in Human Biology and a D.C. in Chiropractic Medicine. In 2011 he earned his Ph.D. in Anatomy and then completed a postdoctoral fellowship in pain research at the Saint Louis University School of Medicine, where he currently teaches and has his lab.

During his clinical training, Little learned about the complexity of pain. Patients can present the same history, signs and symptoms, but treatments are not universal.

“I really wanted to better understand what are the underlying mechanisms that create this chronic pain state. If we understand that, maybe there are parts of that mechanism, a pathway that we can target, to create better ways of managing pain,” Little said.

Little and his team of students and research collaborators examine the behaviors, therapies and potential nervous system mechanisms in preclinical animal pain models. Currently his team is working on collecting data and securing funding to use animal models that better mimic the human condition and have the greatest potential to help more people suffering with pain.

“Our overlying objective is understanding the mechanisms that are causing musculoskeletal pain, in particular chronic pain, especially in conditions that really have a global impact. Of those, low back pain is the number one cause of global disability,” Little said.

In some of his recent studies, Little worked with an international team of researchers to help discover a groundbreaking finding in the field of pain research.

Little said the team found that activating a specific receptor in the brain and spinal cord provides pain relief through the same neurocircuitry used by the body’s natural occurring opioids to suppress pain. Little said this discovery was referred to by science news outlets as a potential “off switch” for chronic pain.

Little admits that not all paths of research lead to substantial discoveries. And that can be difficult.

“There’s not always instant gratification in research,” he said. “You realize all the hard work you do may never have impact…and you have to be okay with that [possibility].”

“In my lab we always keep our focus on the patient and how can we help those folks who are suffering. If you keep that perspective, it helps you to work through a lot of the difficulties in research.”

In addition to his research, Little teaches medical students at the Saint Louis University School of Medicine in his role as Assistant Professor and Director of Research in the Center for Anatomical Sciences and Education, Department of Surgery.

One of the components of his neuroscience lectures is making the connection between emotional and physical pain.

“It’s important for our clinicians to remember that,” Little said. “You’re not just treating someone’s sensation of pain, we need to consider their emotional state as well.”

He also wants his students, including future physicians, to understand how to treat pain effectively even with the current limited understanding of pain and pain therapies.

“A lot of the [treatments] that we use, they don’t work for every type of pain,” Little said. “Even the most effective things that we use have limitations and can also have a negative effect on pain, in that they can enhance the pain state.”

Chronic pain affects millions of people and costs billions of dollars every year. Little is hopeful the research done in his lab will discover new approaches to pain treatment.

His desire to do this research to help others was nurtured during his time at Evangel, both in the classroom and during his time playing for the Evangel Football Team. Little said he applies behaviors he observed in Evangel professors and coaches to his own students.

“All of those experiences were instrumental in helping me become the person that I am now,” he said. “Dedication to students and helping students to develop, whether that is physically, emotionally, mentally or spiritually, I think I take that aspect with me every day when I’m interacting with these students.”

He said he hopes that demonstrating a Christ-like approach as a servant leader makes an impact on his students.

“If students use that [approach],… they’ll be much more successful in actually impacting the lives of their patients,” Little said. “Patients don’t care what you know until they know you care. I hope that they would apply that.”

Little didn’t always want to be a mentor. He thought it would be too time consuming. But he said that after going through that experience with students in his laboratory, he was surprised that it was very rewarding and motivated him to work with more students.

“I have a number of students who are pretty consistently interested in working in my lab,” he said. “I think that demonstrates that the kind of work we’re doing is really meaningful to those who are interested in being clinicians.”

Little said he often struggled with a work-life balance during his years of schooling and training. But after he and his wife, fellow alum and physician Milta (Oyola) Little, had their daughter Audrey, he changed his perspective.

“I won’t even say what the hours were before, but now I’m coming home in time to help out with dinner and bedtime,” Little said. “It really has helped me to prioritize.”

RMC_0853“The research is really important to me, helping out the students is really important to me, but my top priorities are my family and my faith, and I think that certainly helped me to find that work life balance I’ve been trying to achieve.”

In the process of discovering a better balance for his life, he said he was awarded his first research grant.

“There is something about God affirming, ‘Hey you’re doing the right thing, your work matters and you can make this happen and be a good dad and a good husband.’”

Little said he isn’t sure if there will ever be a cure to chronic pain. He said the field of research isn’t close to answering that question yet. But, he is hopeful he can find better treatments to help people like his dad.

“The ultimate goal in my lab… is to keep the focus on trying to make an impact on patients. I just don’t see a reason if we’re not,” Little said. “What we’re doing is really interesting, but we want to help people in the end.”

Christine Temple is former editor-in-chief of The Lance and currently serves as Communication Coordinator at Ozarks Food Harvest.

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