Scientists have found that retraining the way the back and brain communicate can control pain in the region. The research, published in the Journal of the American Medical Association, ignited new hope for people living with chronic back pain.
“What we observed in our study was a clinically significant effect on pain intensity and a clinically significant effect on disability. People were happier, they reported that they felt their back was better and their quality of life was better. effects were sustained over time,” says UNSW (University of New South Wales) School of Health Sciences professor James McAuley.
The nervous systems of people who have chronic back pain behave differently from those who develop a recent low back injury, according to the research on which the study was based.
“People with back pain are often told that their back is vulnerable and needs protection. This changes the way we filter and interpret information from our back and how we move it. Over time, they get less fit and the way they communicate with the brain is interrupted, in a way that seems to reinforce the notion that the back is vulnerable and needs protection. The treatment we devised aims to break this self-sustaining cycle”, says the professor.
Traditional therapies most often seek to fix something in the back, for example, the means of “loosening” joints or strengthening muscles. The training devised by the researchers takes into account the entire system, from what people think about their back, how the back and brain communicate, the ways in which the back moves and even the predispositions of the region.
The research included 276 participants who had chronic low back pain for more than three months. The volunteers were divided into two groups, one for intervention and the other for control.
In the first, patients took a 12-week course focused on sensorimotor retraining that, in short, changed the way they thought about their body, processed sensory information from the pain-stricken part, and the way they moved their back during exercise. activities.
“This treatment, which includes specially designed educational modules and methods and sensorimotor retraining, aims to correct the dysfunction that we now know to be involved in most chronic back pain, and that is a disturbance in the nervous system,” explains the University professor. of South Australia, Lorimer Moseley.
The therapy had three goals: aligning the patient’s understanding with the latest scientific findings about the cause of chronic back pain, normalizing the way the back and brain communicate, and training the body and brain to return to a relationship of common protection and with the possibility of resuming usual activities.
“We think this gives them the confidence to pursue a recovery approach that trains both the body and the brain,” says University of Notre Dame professor and clinical director of the study, Ben Wand.
The other group also underwent weekly clinical sessions and residential training for 12 weeks, but there was no movement re-education or physical activity. The group underwent laser sessions, diathermy on the back (a technique that stimulates heat production) and brain stimulation, as well as techniques to control the placebo effects of the treatments.
In total, it took 18 weeks to significantly decrease the intensity of pain in the patients.
After this period, the group that underwent reeducation reported an improvement in quality of life even one year after the study. Although scientists still consider the improvement in pain intensity to be small, the new treatment encourages the creation of new therapies that, for example, focus on the back, such as spinal manipulation.
Scientists report that few treatments for low back pain show long-term benefits, but the current study achieved the feat of fully recovering twice as many people as the others.
The authors consider that more research is needed to test the treatment in different populations and more specific groups. In addition, the researchers hope to test this approach on other types of pain.
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