Have Chronic Back Pain? This ‘Missing’ Treatment Could Help Millions of People Experiencing Chronic Back Pain, Says New Research

A new study in JAMA Network Open sheds light on the intricate interplay between the brain and chronic back pain.

This groundbreaking study delves deep into ‘pain attributions’ – an individual’s understanding of the origins of their pain. The findings may hold the key to alleviating the suffering of countless individuals grappling with persistent back pain.

“Millions of people are experiencing chronic pain and many haven’t found ways to help with the pain, making it clear that something is missing in the way we’re diagnosing and treating people,” remarked Dr. Yoni Ashar, the study’s lead researcher and an esteemed faculty member at the University of Colorado Anschutz Medical Campus.

Ashar’s team probed the connection between recognizing pain as a product of mental or cerebral processes and the effectiveness of Pain Reprocessing Therapy (PRT). This therapy trains individuals to interpret neural pain signals as less menacing. They aimed to decode the recovery mechanism for chronic back pain sufferers. Post-PRT results showcased a marked reduction in the intensity of back pain.

“Our study shows that discussing pain attributions with patients and helping them understand that pain is often ‘in the brain’ can help reduce it,” Ashar added.

In their pursuit to understand pain perception’s impact, they initiated a randomized trial involving over 150 adults with substantial chronic back pain, introducing them to PRT. The findings were telling: post-PRT, a remarkable two-thirds noted either complete or near absence of pain, in contrast to a mere 20% in the placebo group.

Ashar emphasized, “This study is critically important because patients’ pain attributions are often inaccurate. We found that very few people believed their brains had anything to do with their pain. This can be unhelpful and hurtful when it comes to planning for recovery since pain attributions guide major treatment decisions, such as whether to get surgery or psychological treatment.”

Initially, only 10% of participants linked their pain with cerebral processes in relation to PRT. But post-therapy, this figure jumped to 51%. The data underscored a clear pattern: as participants increasingly recognized pain as a cerebral phenomenon, they reported a more pronounced reduction in their back pain’s intensity.

“These results show that shifting perspectives about the brain’s role in chronic pain can allow patients to experience better results and outcomes,” Ashar added.

Ashar suggests that recognizing pain as a result of brain activity allows patients to realize their bodies aren’t flawed; instead, the pain is akin to a brain-generated ‘misfire’—something they shouldn’t fear.

The study’s implications could be transformative. Ashar hopes healthcare professionals will increasingly engage with patients about non-biomedical pain causes.

“Often, discussions with patients focus on biomedical causes of pain. The role of the brain is rarely discussed,” Ashar added. “With this research, we want to provide patients as much relief as possible by exploring different treatments, including ones that address the brain drivers of chronic pain.”

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