People challenged with chronic back pain have been given hope with a new treatment that focuses on retraining how the back and the brain communicate.
The study divided 276 participants into two groups: one undertook a 12-week course of sensorimotor retraining and the other received a 12-week course of sham treatments designed to control for placebo effects, which are common in low back pain trials.
Professor James McAuley said sensorimotor retraining alters how people think about their body in pain, how they process sensory information from their back and how they move their back during activities.
“What we observed in our trial was a clinically meaningful effect on pain intensity and a clinically meaningful effect on disability. People were happier, they reported their backs felt better and their quality of life was better. It also looks like these effects were sustained over the long term; twice as many people were completely recovered. Very few treatments for low back pain show long-term benefits, but participants in the trial reported improved quality of life one year later.”
The treatment is based on research that showed the nervous system of people suffering from chronic back pain behaves in a different way from people who have a recent injury to the lower back.
Professor Lorimer Moseley said, “This treatment, which includes specially designed education modules and methods and sensorimotor retraining, aims to correct the dysfunction we now know is involved in most chronic back pain and that’s a disruption within the nervous system. The disruption results in two problems: a hypersensitive pain system and imprecise communication between the back and the brain.”
The new treatment challenges traditional treatments for chronic back pain, such as drugs and treatments that focus on the back such as spinal manipulation, injections, surgery and spinal cord stimulators, by viewing long-standing back pain as a modifiable problem of the nervous system rather than a disc, bone or muscle problem.
Prof. McAuley said: “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.”
Matthew K. Bagg, Benedict M. Wand, Aidan G. Cashin, Hopin Lee, Markus Hübscher, Tasha R. Stanton, Neil E. O’Connell, Edel T. O’Hagan, Rodrigo R. N. Rizzo, Michael A. Wewege, Martin Rabey, Stephen Goodall, Sopany Saing, Serigne N. Lo, Hannu Luomajoki, Robert D. Herbert, Chris G. Maher, G. Lorimer Moseley, James H. McAuley. Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain. JAMA, 2022; 328 (5): 430 DOI: 10.1001/jama.2022.9930
University of New South Wales. “An effective new treatment for chronic back pain targets the nervous system.” ScienceDaily. ScienceDaily, 2 August 2022. <www.sciencedaily.com/releases/2022/08/220802121722.htm>.
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