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Dr Laurent Grange (Rheumatologist)
According to a study, re-appropriating persistent back pain and thinking about it differently may be effective in quieting the pain in many cases. What does our rheumatologist, Doctor Laurent Grange, think?
Back pain, described as the evil of the century, impacts 4 out of 5 French people at least once in their life. But people with persistent back pain often have a clear idea of the cause: they attribute it to an injury or another problem like arthritis, which would make the pain pervasive and difficult to combat. However, according to a new study, rethinking pain as coming from the brain and not from the back itself could result in simply curing this condition.
Reattributing pain to a mental process
The study started from an observation: certainly pain can find its origin in an injury, but the biological pain system would remain blocked in this process, even if the injury had healed.
The researchers then decided to evaluate the effectiveness of a psychological treatment called “pain reprocessing therapy” on chronic back pain. To do this, 151 adults suffering from persistent back pain were included in a cohort. The participants thus received the real therapy, a placebo. Interventions included cognitive, behavioral, and somatic techniques to help reattribute pain to non-dangerous, reversible mental or brain causes.
And the results are conclusive: 66% of participants treated with pain reprocessing therapy said they no longer felt any or almost no pain, compared to only 20% of people who received the placebo therapy.
“These results are remarkable because previous trials of psychological treatments have rarely resulted in complete cure for chronic pain,” estimate the researchers.
Rethinking pain, a treatment option for lasting pain?
Above all, these results demonstrate that back pain that becomes chronic is caused by changes in the brain, and not an injury that persists. In this sense it would be important to consider this dimension when seeking treatment.
An interesting option for Dr Laurent Grange, rheumatologist and member of our expert committee. “We know in fact that 7% of low back pain today becomes chronic and leads to autonomy at the central level, that is to say cerebral, even though the initial lesions diminish or disappear. This can be due to personal or professional environment, beliefs, etc. It’s on this type of case that it can work.”
The doctor indicates that the recommendations of the High Authority of Health also go in the direction of non-drug treatment with the intervention of a psychologist and CBT (behavioral and cognitive therapies) for persistent back pain.
“We need to get a little closer to what is done in this study. The idea is to change the minds of patients and make them understand that their pain is not or no longer of organic origin, but of psychological origin, linked to stress, etc. Through these techniques, they reprogram the brain and patients have less pain. It remains to be seen how the researchers proceeded exactly (the study does not detail the therapy). But yes, it This is an interesting idea because 12 to 33% of French people, and readers for example, have back pain at this very moment.”
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