- A new study points to the role our psychology plays in chronic back pain.
- To address how our mind plays into pain, researchers had chronic back pain sufferers participate in twice-weekly therapy sessions to discuss causes of back pain and found promising results.
Although chronic pain anywhere in the body can be exhausting and limiting, back pain is particularly problematic when it comes to your quality of life, research suggests, and that includes both physical function and emotional health.
The link to psychological wellbeing goes in the other direction as well, according to a study in JAMA Network Open. That means chronic back pain may lead to distress—but it’s also shown that mental difficulties can worsen or even cause the pain in the first place.
If that’s the case, could you reduce back pain simply by retraining your brain? The possibility is intriguing, according to lead researcher Yoni Ashar, Ph.D., assistant professor in the department of medicine at the University of Colorado Anschutz.
“The belief is often that pain is due to an issue like a bulging disc or osteoarthritis,” said Ashar. “But those tend not to be the predominant cause of symptoms. Instead, the majority of chronic back pain is driven by mental processes that promote fear of the persistence of pain.” In turn, that can lead to poor behavioral strategies like avoiding use of back muscles or resting too much, he added.
Because of this, Ashar and his colleagues have been studying a psychological treatment called pain reprocessing therapy, which could help “turn off” pain signals in the brain, he told Bicycling. This approach combines cognitive, behavioral, and physical techniques focusing on the perception of pain.
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The recent study involved 151 adults with chronic back pain, who were placed in either a placebo group or a pain reprocessing group. Those in the latter group had eight one-hour sessions with a therapist twice weekly for four weeks. After that time, 66 percent of those participants reported being pain-free or nearly pain-free after the therapy, compared with 20 percent of people receiving the placebo.
“These results were remarkable, because previous trials of psychological treatments rarely led to people reporting full recoveries from chronic pain,” said Ashar.
Pain reprocessing took a different approach, asking participants for their ideas on what was causing their pain. Although many initially felt injuries or weak muscles were the culprits, subsequent discussions about fear and anxiety led to a new understanding of how those could be connected to back pain, he added.
“The more that people shifted toward [realizing the connection of pain to fear and anxiety], the more their back pain went down,” said Ashar. “Because it reduced fear and avoidance of pain, this understanding can tamp down pain pathways in the brain and lead to healthy, pain-reducing behaviors like exercise.”
For those who don’t have access to therapies like these, Ashar said that simply acknowledging that the brain—particularly emotional processes—can be playing a major role in your chronic back pain can help reframe beliefs about what’s causing the pain. A new perspective like that might not knock out your pain completely, but he added that it may lower pain levels enough for the issue to be much more manageable and help you move through it.
Elizabeth Millard is a freelance writer focusing on health, wellness, fitness, and food.
