HEALTHPLAN MAGAZINE

Chronic pain can manifest in various parts of the body, but one of the most prevalent forms is chronic back pain.

Recent research conducted by Dr. Yoni Ashar, an assistant professor of internal medicine at the University of Colorado Anschutz Medical Campus, provides compelling evidence supporting the effectiveness of brain-based treatments for chronic back pain.

Dr. Ashar, the lead author of the study, explains, "For decades, studies have tried to link back pain to back problems like bulging discs or bad posture. It turns out these sorts of things only cause relatively few cases of chronic back pain. Most cases of chronic back pain are caused primarily by brain changes, like the brain amplifying signals it receives from the back."

Around 20% of the world’s population suffer from back pain

Chronic pain is a widespread issue, affecting an estimated 20% of the global population, a condition characterised by persistent pain lasting for three months or more. In the United States, where back pain is a prominent concern, a 2019 study revealed that 39% of adults live with back pain. Furthermore, chronic low back pain, recognised as a leading global cause of disability, afflicts up to 23% of the world's population.

Dr. Ashar emphasises two crucial points: "First, the pain is always real. Sometimes, it can be caused by issues in the back, and sometimes it can be caused by changes in the brain — but in all cases, the pain is real. Second, the sorts of brain changes we are talking about are completely reversible, and recovery from pain is possible."

Traditional treatment options for chronic back pain encompass medications, physical therapy, acupuncture, epidural steroid injections, and surgery. In addition to these approaches, research has also highlighted the effectiveness of behavioural modification techniques such as meditation and cognitive behavioural therapy.

Chronic back pain can affect any part of the spine, although it most commonly manifests in the lumbar spine. However, pinpointing the exact location of back pain can sometimes be challenging.

Dr. Ashar suggests a change in perspective regarding the cause of pain: "It may be helpful for doctors to help their patients see their pain as due to fear, avoidance, or brain processes, rather than injury or damage. In our study, the more people shifted to seeing their pain as caused by something in the mind or brain, the more their pain was reduced."

Pain processing therapy

The recent study delved into pain reprocessing therapy, a psychological treatment designed to help individuals perceive pain signals to the brain as less threatening. Chronic pain often results from a cycle of fear and avoidance, where patients associate pain with injury or damage, leading to heightened pain perception. Shifting this perception to recognise pain as a result of misfiring brain pathways enables patients to reduce fear and avoidance, ultimately recalibrating these brain pathways to diminish pain.

The study enrolled 151 participants with chronic back pain, with one group undergoing pain reprocessing therapy and the other receiving a placebo. Remarkably, two-thirds of those who underwent pain reprocessing therapy reported being pain-free or nearly so after the treatment, compared to just 20% in the placebo group.

This groundbreaking research underscores the significance of mental well-being in chronic back pain treatment. A positive mental state can significantly impact pain management outcomes, alongside conventional treatments and interventions. The findings offer newfound hope to chronic back pain sufferers and emphasise the importance of addressing the mind-body connection in effectively managing chronic pain.

Source: Medical News Today