Effective new treatment for chronic back pain targeting nervous system

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, a randomised controlled trial run by researchers at UNSW Sydney and Neuroscience Research Australia (NeuRA) and several other Australian and European universities has shown.

The study, carried out at NeuRA, 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 from UNSW's School of Health Sciences, and NeuRA 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.

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.

The treatment aims to achieve three goals. The first is to align patient understanding with the latest scientific understanding about what causes chronic back pain. The second is to normalise the way the back and the brain communicate with each other, and thirdly, to gradually retrain the body and the brain back to a normal protection setting and a resumption of usual activities.

Traditional therapies concentrate on fixing something in your back, injecting a disc, loosening up the joints or strengthening the muscles. What makes sensorimotor retraining different, according to Prof. McAuley is that it looks at the whole system – what people think about their back, how the back and brain communicate, how the back is moved, as well as the fitness of the back.

Ref: Professor James McAuley et. al, Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic LowBack Pain, Journal of the American Medical Association, 2-Aug-2022, DOI: 10.1001/jama.2022.9930