What to do when back pain doesn’t go away and becomes chronic? Once physical causes that can be treated with the help of a doctor, such as fractures, infections or inflammation, have been excluded, there is a therapy that is giving notable results and that focuses… on what we think. Changing some ways of thinking has in fact helped the majority of study participants to definitively get rid of chronic back pain without the use of drugs, as emerges from a very recent scientific research published in the journal JAMA Network Open thanks to an American team from the University of Colorado (Ashar et al, JAMA Network Open, Sep 2023).When chronic pain is a false signal from the brainScientists started from the assumption that most people believe that, in the case of chronic back pain, the cause is due to physical problems such as arthrosis or spinal problems such as disc protrusion. In these conditions, people tend to tense up, not engage in physical activity and focus on the pain, which inevitably does not go away or even gets worse. Instead, in most cases of chronic pain, such as back pain but also tension headaches, pain is generated by central upregulation and learning processes aimed at protecting oneself from threats. Let’s be clear, pain is real, scientists aren’t saying it’s just in our heads. The pain is there. But, in most cases, it is not generated by an existing physical problem but rather by a false signal from the brain indicating that there is damaged tissue, which is actually healthy. This process can be reversed. However, it should be underlined that what has been stated is only valid when the doctor has excluded physical causes of back pain such as fractures, arthrosis, infections or hernias.How chronic back pain can heal permanentlyScientists recruited 150 adults, all aged between 21 and 70 and with chronic back pain of moderate intensity. For a diagnosis of chronic back pain, volunteers had to have had back pain on at least half the days in the past six months. Then, the pain had not to be of physical origin. The volunteers were divided into three groups. The first group had to receive a placebo injection, the second the normal medical treatment required by the case and the third a therapy called pain reprocessing. In practice, this last group had to participate in online sessions for 4 weeks in which it was explained to them that the cause of pain may be a false signal from the brain. Not only that, this group also had to participate in lessons in which it was explained to them that stress, depression or negative emotions could often be the cause of pain, in meditation sessions to help them stay in the here and now to detach themselves from obsessive thoughts and in training in which positions that could cause pain were addressed. Well, after 4 weeks the majority of those who had been assigned to the latter group no longer had back pain. Instead, only less than a fifth of the people assigned to the first and second groups, that is, those who received a placebo injection and the usual treatment, were free of back pain.Back pain and depressionThis study is in line with another very recent study published in the International Journal of Environmental Research and Public Health by a team from the University of Hawaii (Yang et al, Int. J. Environ. Res Public Health, 2023). Well, scholars have observed that chronic lower back pain is linked to depression. In particular, pain causes depression but depression itself also causes pain. This research also shows the link between pain, back and brain. It is believed that the condition of depression leads to greater sedentary behavior, often being stiff and contracted and this increases the risk of back pain.ConclusionsToday’s two articles show a new approach to treating chronic back pain. We are often led to believe that the cause is physical and difficult to treat, thus causing a vicious circle in which we do not move, we remain rigid, contracted and focused on the pain, which persists or even increases. Instead, in most cases, chronic pain can come from a false signal from the brain and our mind can be re-educated, leading to a resolution of symptoms. This applies to back pain but also, as mentioned by researchers, to other types of chronic pain, such as headaches. It should be underlined that, in case of chronic pain, it is also important to contact your doctor as sometimes the cause can be of a different type, such as an infection, a fracture or inflammation, which must be treated appropriately.
