New treatment retrains the brain to successfully deal with chronic back pain

KENSINGTON, Australia — Scientists in Australia have developed the first effective treatment for back pain which changes how the brain and back communicate with each other.

The 12-week course, which focuses on the patient’s nervous system and pain manipulation rather than using painkillers, leaves twice as many people pain-free as conventional treatment. Researchers say the system, called sensorimotor retraining, changes how people think about their body in pain, how they process sensations from their back, and how they move their back as they go about daily lives.

People who participated in the treatment reported that they were happier, their backs felt better, and they had a better quality of life. The improvements remained a year later, while most existing treatments for low back pain don’t last nearly as long.

Study authors note that the treatment is different to existing treatments for back pain, including spinal manipulation, injections, surgery, and spinal cord stimulators, because it sees back pain as a changeable problem in the nervous system rather than a disc, bone, or muscle problem.

It includes education as well as sensorimotor retraining. Study authors note that the process is based on research that shows the nervous system of people who suffer from chronic back pain behaves in a different way in comparison to people who have had a recent injury to their lower back.

They add that, because people often hear their back is vulnerable and needs protecting, this changes the way the back and brain communicate — with the back receiving messages that it is vulnerable. It becomes weaker in the process and the team hopes their treatment can stop this self-fulfilling pattern.

The treatment aims to correct two problems common in back pain: a hypersensitive pain system and bad communication between the brain and back. The authors say people can see their back and brain are not communicating well and slowly learn to train their brain and body to fix the problem.

Normally, back therapies focus on fixing something in the back straight away, such as injecting a disc, loosening up joints, or strengthening muscles. This one is different because it gets people to think about their back as a whole.

For the study, the team split 276 people into two groups, one who did the therapy for 12 weeks and another who received a “placebo” therapy for the same amount of time. Trained physiotherapists, exercise psychologists, and other experts helped to deliver the therapy to each patient.

“This is the first new treatment of its kind for back pain – which has been the number one cause of the Global Disability Burden for the last 30 years – that has been tested against placebo,” says study author Professor James McAuley in a university release.

“If you compare the results to studies looking at opioid treatment versus placebo, the difference for that is less than one point out of 10 in pain intensity, it’s only short term and there is little improvement in disability. We see similar results for studies comparing manual therapy to sham or exercise to sham,” Prof. McAuley adds.

The findings are published in the Journal of the American Medical Association.

South West News Service writer Gwyn Wright contributed to this report.

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