Low back pain is tackled with nervous system retraining

Low back pain is tackled with nervous system retraining


Newsroom of the Diário da Sade

sensorimotor retraining

People with chronic back pain, especially low back pain, have new hope for the condition, which is currently incurable.

The alternative lies in a new treatment that focuses not on drugs but on retraining how the back and brain communicate.

Sensorimotor retraining changes the way people think about their bodies in pain, how they process sensory information from the back, and how they move their back during activities.

The new treatment was the subject of a randomized controlled trial, the most rigorous method of scientific evaluation of a drug or treatment, which has just been carried out by doctors and researchers from the University of New South Wales and several other Australian and European universities.

The trial involved 276 patients, divided into two groups: One group received a 12-week course of sensorimotor retraining, while the other received a 12-week course of sham treatments designed to control for placebo effects, which are common in trials. of low back pain.

“What we observed in our trial was a clinically significant effect on pain intensity and a clinically significant effect on disability. People were happier, reported that their back improved and their quality of life was better. It also appears that these effects were sustained. in the long term; twice as many people were completely recovered. Very few treatments for low back pain show long-term benefits, but trial participants reported improved quality of life one year later,” said Professor James McAuley, study coordinator.

rethink the pain

The treatment is based on research that has shown that the nervous system of people who suffer from chronic back pain behaves differently from the nervous system of people who have a recent low back injury.

“People with back pain are often told that their back is vulnerable and in need of protection. This changes the way we filter and interpret information from our back and how we move it. Communication is disrupted in ways that seem to reinforce the notion of that the back is vulnerable and needs to be protected,” McAuley explained.

In this new view, back pain is seen as a modifiable problem of the nervous system—rather than a disc, bone, or muscle problem. In doing so, the new treatment challenges traditional treatments for chronic low back pain, such as drugs and treatments that focus on the back, such as spinal manipulation, injections, surgery, and spinal cord stimulators.

“If you compare the results with studies looking at treatment with opioids versus placebo, the difference for that is less than one point in 10 in pain intensity, only short-term and there is little improvement in disability. We see similar results for studies comparing therapy manual with imitation or exercise with imitation,” said prof. McAuley.

With the results of the clinical trial, the team expects the new treatment to be available in the next six to nine months, through physical therapists, physiologists and other clinicians. Prof. McAuley says that people with chronic back pain should have access to technique at a cost similar to traditional therapies offered by these professionals.

Check with scientific article:

Article: Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic LowBack Pain
Authors: Matthew K. Bagg, Benedict M. Wand, Aidan G. Cashin, Hopin Lee, Markus Hbscher, Tasha R. Stanton, Neil E. OConnell, Edel T. OHagan, Rodrigo RN Rizzo, Michael A. Wewege, Martin Rabey, Stephen Goodall, Sopany Saing, Serigne N. Lo, Hannu Luomajoki, Robert D. Herbert, Chris G. Maher, G. Lorimer Moseley, James H. McAuley
Publication: Journal of the American Medical Association
DOI: 10.1001/jama.2022.9930

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