But new research suggests the solution for the world's leading cause of disability may lie in fixing how the brain and the body communicate.
Are you among the hundreds of millions of people worldwide with low back pain? If so, you may be familiar with standard treatments like surgery, shots, medications, and spinal manipulations.
Setting out to challenge traditional treatments for chronic back pain, scientists across Australia, Europe, and the U.S. came together to test the effectiveness of altering how neural networks recognize pain for new research published this week in the Journal of the American Medical Association.
The randomized clinical trial recruited two groups of 138 participants with chronic low back pain, testing one group with a novel method called graded sensorimotor retraining intervention (RESOLVE) and the other with things like mock laser therapy and noninvasive brain stimulation.
The researchers found the RESOLVE 12-week training course resulted in a statistically significant improvement in pain intensity at 18 weeks.
“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,” the study’s lead author, James McAuley, Ph.D., said in a statement. “This is the first new treatment of its kind for back pain.”
Communication between your brain and back changes over time when you have chronic lower back pain, leading the brain to interpret signals from the back differently and change how you move. It is thought that these neural changes make recovery from pain slower and more complicated, according to the Neuroscience Research Australia (NeuRA), a nonprofit research institute in Sydney, Australia.
“Over time, the back becomes less fit, and the way the back and brain communicate is disrupted in ways that seem to reinforce the notion that the back is vulnerable and needs protecting,” said McAuley, a professor at the University of New South Wales and a NeuRA senior research scientist. “The treatment we devised aims to break this self-sustaining cycle.”
RESOLVE treatment focuses on improving this transformed brain-back communication by slowly retraining the body and the brain without the use of opioids or surgery. People in the study have reported improved quality of life 1 year later, according to McAuley.
The researchers said the pain improvement was “modest,” and the method will need to be tested on other patients and conditions. They hope to introduce this new treatment to doctors and physiotherapists within the next 6 to 9 months and have already enlisted partner organizations to start this process, according to NeuRA.