Study shows brain retraining therapy can help reduce chronic back pain

By Stephen Beech via SWNS

The mind is key to relieving chronic back pain, according to a new study.

Two-thirds of the patients reported being pain-free or nearly so after being taught to perceive pain signals from their back to their brain as less threatening.

The study, published in JAMA Network Open, examined the critical connection between the brain and pain.

The research team looked at the importance of pain attributions, which are people’s beliefs about the underlying causes of their discomfort, to reduce chronic back pain severity.

Study first author Dr. Yoni Ashar said “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,”

Dr. Ashar and his colleagues tested whether the reattribution of pain to mind or brain processes was associated with pain relief in pain reprocessing therapy (PRT), which teaches people to perceive pain signals sent to the brain as less threatening.

Their goal was to better understand how people recovered from chronic back pain.

The study found that, after PRT, patients reported reduced back pain intensity.

Dr. Ashar, Assistant Professor of internal medicine at the University of Colorado Anschutz Medical Campus, said: “Our study shows that discussing pain attributions with patients and helping them understand that pain is often ‘in the brain’ can help reduce it."

To study the effects of pain attributions, the researchers enrolled more than 150 adults experiencing moderately severe chronic back pain in a trial to receive PRT.

The team found two-thirds of people treated with PRT reported being pain-free or nearly so after treatment, compared to just one in five (20 percent) of those who did not receive PRT.

Dr. Ashar said: “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."

Before PRT treatment, only 10 percent of participants’ attributions of PRT treatment were mind- or brain-related. However, after PRT, that increased to 51 percent.

The study revealed that the more participants shifted to viewing their pain as due to mind or brain processes, the greater the reduction in chronic back pain intensity they reported.

Dr. Ashar said: “These results show that shifting perspectives about the brain’s role in chronic pain can allow patients to experience better results and outcomes."

He says that one reason may be that when patients understand their pain as due to brain processes, they learn that there is nothing wrong with their body and that the pain is a ‘false alarm’ being generated by the brain that they don’t need to be afraid of.

The research team hopes the study will encourage medics to talk to their patients about the reasons behind their pain and discuss causes outside of biomedical ones.

Dr. Ashar added: “Often, discussions with patients focus on biomedical causes of pain.

"The role of the brain is rarely discussed.

“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.”