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A new drug-free treatment that ‘retrains’ the brain can offer better long-term relief from back pain than opioids, a study has suggested.
Patients saw significant improvements after the 12-week course, which consisted of one hour with a physiotherapist each week.
Dr Neil O’Connell, who worked on the trial at Brunel University, London, said: ‘These results show real promise.’
Around 11million people in the UK and 65million in the US suffer back pain, making it the leading cause of disability.
Traditional therapies concentrate on fixing something in the back, such as injecting a disc, manipulating joints, strengthening the muscles or surgery.
But ‘sensorimotor retraining’ changes the way people think about their condition, so they no longer see it as a defect or barrier to movement.
Patients seeking treatment for back pain reported significant improvements after the 12-week course of one-hour therapy, which consisted of one hour with a therapist each week
Researchers at the University of New South Wales tested the therapy on 276 patients with chronic lower back pain.
Half completed the sensorimotor course and the rest given ‘sham’ treatments.
Participants had an average age of 46, and were split evenly in terms of gender.
Patients on the course undertook physio sessions that taught them how back pain was a modifiable problem of the nervous system, rather than a physical issue.
During the process, they also watched videos of other people bending and standing up.
This is because just thinking about the movements can activate some of the same pathways as actually doing them, the researchers say.
After learning to consider their pain in a different light, participants progressed to attempting more complex manoeuvres, such as squats and lunges.
They also repeated some of these exercises at home for 30 minute sessions five times per week.
The idea behind the retraining is that patients with lower back pain often have less fit backs because they shy away from physical activity in an attempt to soothe themselves.
This sheltering disrupts the normal way the brain and back communicate via the nervous system, making it hypersensitive to pain.
As a result, the researchers claimed it can leave sufferers in a self-sustaining cycle that only worsens their condition.
The sensorimotor retraining aimed to break this cycle and help the brain to communicate with the back normally.
After 18 weeks, participants were asked to rate their back pain out of 10 and this was compared to the score at the start of the study.
Retraining patients saw their pain score decrease from 5.6 to 3.1, on average.
Patients in the sham treatment group, which involved zapping their back with lasers and weak electrical currents, only had their average pain scores decrease from 5.8 to 4.
After 26 weeks, 18.3 per cent of the sensorimotor group met the criteria for ‘recovery’, compared with only 9.8 per cent in the sham group.
Professor James McAuley, a psychologist at the University of New South Wales who also worked on the study, said the results challenged the current treatment methods for chronic back pain like using opioid painkillers.
‘If you compare the results to studies looking at opioid treatment versus placebo, the difference for that is less than one point out of 10 in pain intensity, it’s only short term and there is little improvement in disability,’ he said.
He added the sensorimotor retraining had made an incredible and long-term difference to how the patients dealt with their pain.
‘People were happier, they reported their backs felt better and their quality of life was better,’ he said.
‘It also looks like these effects were sustained over the long term; twice as many people were completely recovered.
‘Very few treatments for low back pain show long-term benefits, but participants in the trial reported improved quality of life one year later.’
The therapy could be more widely available in six to nine months. The findings were published in the Journal of the American Medical Association.
Using drugs in pain management has come under scrutiny in recent years due to a rise in opioid addiction in the US.
There are also fears of a similar burgeoning crisis in the UK, with opioid hospitalisations soaring over the last decade as more Britons turn to painkillers while on NHS waiting lists for operations like hip or knee replacements.