Algorithm-informed Decision-making to Advance Pain Treatment

During the treatment stages participants may be placed into the following interventions: 1. Physical Therapy \& Exercise -10, standardized sessions over 8 weeks delivered individually and in-person by a physical therapist 2. Duloxetine - FDA approved for musculoskeletal pain, self-administered SNRI medication taken daily over 8 weeks. 3. Acupressure- a mobile health program- self-administered mHealth program with daily practice over 8 weeks. 4. PRISM- cognitive-behavioral therapy plus resilience training- 8, weekly, digitally delivered pain self-management modules with corresponding weekly 15-minute standardized telehealth coaching sessions. After participants are placed in an initial assignment based on a combination of the use of the phenotype based algorithm and randomization, they have the option of continuing on that treatment, switching to another (to be assigned by another randomization combined with use of the algorithm) or adding a second treatment to the first (to be assigned by another randomization combined with use of the algorithm). Analysis of results will not be a function of the arms listed here, but on whether those allocations were based on the algorithm assigning them initially to their presumed "most effective" treatment; or to a potentially less effective treatment (2nd, 3rd or 4th, choice). These "ranked phenotypic" assignments are masked from participants and researchers until after the trial is completed.