Like phantom pain for amputees, when the brain believes that a part of the body is injured, pain messages often continue unabated – even after the afflicted area has healed.
A study conducted by researchers at the University of Colorado Anschutz Medical Campus reinforces the idea that many cases of chronic back pain are driven by the brain. The study, published in JAMA Network Open, showed that pain reprocessing therapy (PRT) resulted in two-thirds of the study participants being pain-free or nearly so after nine weeks. These pain reductions were explained by shifts in patients’ views on the roots of their pain – moving these thoughts from body-focused to mind-related causes.
“Pain is our way of protecting us,” said Yoni Ashar, PhD, assistant professor of internal medicine at the CU School of Medicine and the study’s lead author. “Sometimes (the brain) is mistaken and the pain at that point is like a false alarm – meaning the alarm is going off but actually the body is healthy and sound. Maybe there are a few wisps of smoke, but there’s no fire in the body.”
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Health Science Radio. |
In this inaugural episode of Health Science Radio (HSR), Ashar shares the study’s findings and explains how PRT works as a therapy for chronic pain recovery.
Patients aren’t exaggerating about their pain, he emphasizes. In the study, the key was to first get participants to explain what they thought caused their pain. In the talk therapy sessions, their initial explanations were body-related roots of pain – ski accidents, sedentary lifestyle, active lifestyle, bad posture, etc. Researchers discovered that the more the patients shifted to mind-related causes of pain, the more their pain decreased.
“We’re trying to teach patients a specific set of techniques for retraining their brains to feel safe or to interpret those sensations from the body through a lens of safety,” he said. “And then the brain will start to bring down that danger level and the pain can start to come down.”
In this episode of HSR, Ashar discusses the potential for PRT to go beyond just relieving patients’ sensations of pain, to helping them recover from their pain.
“It’s not learning how to live with your pain; it’s unlearning pain and getting rid of the pain,” he said. “That’s a very exciting possibility that you could actually do something with your mind, with your beliefs, with your emotional state that then causes the pain to dwindle and ultimately vanish – or more or less vanish. … There is still a lot left to understand in terms of how the brain learns pain and how the brain can unlearn it, but we’re working on that and trying to unpack it.”
In the podcast, Ashar talks about expanding the research into other common types of pain, including migraine headaches.
Photo at top: Thomas Flaig, MD, vice chancellor for research at CU Anschutz, left, chats with Yoni Ashar, PhD, assistant professor of internal medicine.