Inclusion Criteria:  Veteran History of (chronic) musculoskeletal-related pain conditions recorded in the EHR in the year prior to the index visit, and self-report pain present every day or nearly every day for 3 months from the CIH index visit using an eligibility screener 18-89 on index CIH visit date  Exclusion Criteria:  diagnoses of serious mental illness in the year prior to initiating CIH history of spinal cord injury hospitalization 30 days prior to initiating CIH recorded CIH use in the EHR in the 6 months prior to the index CIH visit and reported CIH use in the 8 weeks prior to index CIH visit