Many individuals with chronic back pain commonly attribute their discomfort to physical injuries or issues within the body, such as arthritis or bulging disks. However, our research team has discovered that framing the root cause of pain as a process occurring in the brain can facilitate a faster recovery. This pivotal finding emerged from a study recently published in JAMA Network Open, a monthly open-access medical journal.
We have been investigating a psychological treatment known as pain reprocessing therapy, aiming to “turn off” unhelpful and unnecessary pain signals in the brain. In a study involving 151 adults aged 21 to 70 with chronic back pain, some received pain reprocessing therapy, while others received a placebo injection into their backs. Remarkably, 66% of those undergoing pain reprocessing therapy reported being pain-free or nearly pain-free, compared to 20% of the placebo group.
This outcome is noteworthy as prior trials of psychological treatments rarely resulted in full recoveries from chronic pain. To comprehend how this treatment works, we explored changes in participants’ thinking that contributed to their recovery from chronic back pain.
The significance of this research lies in addressing chronic pain, a pervasive health issue and the leading cause of disability in the U.S., with economic costs surpassing those of diabetes or cancer. Commonly associated with bodily factors, back pain is increasingly believed by scientists to stem from brain changes, where the pain system becomes “stuck” and persists long after injuries heal.
Chronic pain involves alterations in the brain’s pain processing pathways and increased activity in glial cells, part of the brain’s immune system. Despite the genuine nature of the pain, accurately identifying the root cause is essential for effective treatment. While participants initially described bodily factors as the causes of their pain, pain reprocessing therapy aimed to shift their understanding towards mind or brain-related causes, such as anxiety or neural pathways. This change in perception correlated with a reduction in back pain, suggesting that altering one’s understanding can diminish fear and avoidance behaviors, promoting healthier, pain-reducing activities like exercise and socializing.
Accurate identification of the underlying causes of pain stands as the initial step toward its healing.