A University of Colorado Boulder-led research showed that psychological treatment could provide lasting relief to patients suffering from chronic pain.
According to a news release in CU Boulder Today, the research provides the strongest evidence that the brain can generate pain in the absence of an injury or even when it has completely healed. The psychological treatment called Pain Reprocessing Therapy (PRT) used in the study proves that people can unlearn chronic pain.
What Causes Chronic Pain?
According to Cleveland Clinic, chronic pain ai the kind of pain that lasts for more than three months. It may come and go and happen everywhere in the body, which could disrupt daily activities. It continues long after recovery from an injury and even happens for no apparent reason, unlike acute pain that only happens when a person gets hurt and goes away after healing.
The news release reported that approximately 85% of people suffering from chronic back pain have "primary pain." That means the source of their bodily pain is unknown as tests showed no tissue damage, osteoarthritis, or disc degeneration.
Previous studies have shown that chronic back pain could be partially blamed on misfiring neural pathways because certain brain regions, including those responsible for the reward and fear, activate during chronic pain. More so, specific neural networks on chronic pain patients tend to overreact to even the mildest stimuli.
Pain Reprocessing Therapy (PRT) Could Silence the False Alarm
Lead author Yoni Ashar said that misfired neural pathways that cause primary chronic pain is like a false alarm that is always "on." He and his team thought of using PRT to silence this alarm by thinking that pain is safe so patients can alter brain networks responsible for pain and neutralize it.
Pain psychologist Alan Gordon developed PRT to teach patients about the brain's role in generating chronic pain. This will help them evaluate their pain as they engage in movements that they are otherwise afraid to do and will help them address emotions that worsen their pain.
The team recruited 151 participants who suffered from chronic back pain at an intensity of four out of ten for at least six months. They all underwent fMRI scans to measure how their brain reacted to mild pain. Then, they were divided into groups in which one group was subjected to eight one-hour sessions of PRT, another group received a placebo, and another group did not receive any treatment.
In the end, most patients experienced benefits in PRT, as observed by the researchers. Ashar said that the magnitude and durability of the pain reduction they observed in the study were rarely seen in other types of chronic treatment trials, not even in opioid clinical trials that only yielded moderate and short-term relief.
According to the news release, 66% of the patients in the treatment group reported being pain-free or nearly pain-free, while only 20% of those in the placebo group and 10% of the no-treatment group reported similar results after PRT. Also, brain scans after the treatment showed that brain regions associated with pain processing had been silenced.
Disclaimer: Pain is Not "All in the Head"
Researchers noted that psychological therapy does not suggest that pain is not real and is all in the head. The study suggests that there could be solutions other than drugs, like the highly addictive opioid, if the causes of pain are in the brain.
They emphasize that this kind of treatment does not apply to secondary pain caused by acute pain. The team recommends conducting a larger study to determine if this psychological treatment could also treat other types of chronic pain, aside from chronic back pain.
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