A randomized controlled study has found a new treatment for chronic back pain that concentrates on retraining how the back communicates with the brain.1✅ JOURNAL REFERENCE
DOI: 10.1001/jama.2022.9930
The researchers separated 276 individuals into 2 groups: 1 group was given sensorimotor retraining for 12 weeks and the other group was given sham treatment for 12 weeks intended as a placebo, which is typical in studies on low back pain.
Sensorimotor retraining changes the way individuals think about pain in their body, how sensory information from the back is processed, and how the back moves while engaging in activities.
The study results showed a clinically significant effect on disability as well as pain intensity. Individuals were happier, their backs were improved and their quality of life was improved. These effects were also sustained long term with study participants reporting better quality of life a year later.
This treatment is in contrast to traditional chronic back pain treatments, which include medications and treatments that target the back like spinal cord stimulators, surgery, injections, and spinal manipulation, by looking at chronic back pain as a modifiable nervous system problem as opposed to a muscle, bone or disc problem.
The treatment stems from research that found the nervous system of individuals struggling with chronic back pain acts differently from individuals who have a recent lower back injury.
Individuals with back pain are usually informed that their back is vulnerable and requires protection. This alters how information from the back is filtered and interpreted and how the back is moved. The back becomes unfit with time, and back and brain communication is disrupted in a way that appears to reinforce the idea that the back is vulnerable and requires protection. The aim of the treatment the researchers developed is to break this self-sustaining cycle.
The treatment, which includes sensorimotor retraining and specially developed education methods and modules, is designed to correct the nervous system disruption which is a dysfunction known to be involved in most chronic back pain. The disruption leads to 2 problems: inaccurate communication between the back and the brain and a hypersensitive pain system.
The treatment is designed to accomplish 3 things. The 1st is aligning patient understanding with up to date scientific knowledge regarding the causes of chronic back pain. The 2nd is to normalize how the back and the brain is communicating with one another, and thirdly, to slowly but surely retrain the body and the brain back to a normal protection environment and resume normal activities.
A sensorimotor training program can show individuals that their brain and back aren’t communicating well, and can also improve this communication.
According to the researchers, traditional therapies focus on repairing something in the back, strengthening the muscles, loosening up the joints, or injecting a disc. Sensorimotor retraining considers the whole system, how the back and brain communicate, how individuals perceive their backs, how the back is moved, and also the back’s fitness.
