You Can Rewire Your Brain to Eliminate Chronic Back Pain

A groundbreaking new study shows the remarkable efficacy of a brain-based treatment for chronic back pain. It provides new hope for a debilitating problem.

One in five Americans suffers from chronic pain, most often without receiving many benefits from invasive and costly treatments.

The most common type of chronic pain is chronic back pain- in 85% of cases of which no physical cause can be identified.

Dr. Yoni Ashar is a clinical psychologist and neuroscientist who studies psychological treatments for chronic pain. He recently led a study at the University of Colorado Boulder to determine whether a psychological treatment can eliminate chronic back pain — something no other therapy has ever before been scientifically proven to do.

“Our society predominantly thinks about chronic pain through a biomechanical, medical perspective. The most common treatments are physical; they’re injections or physical therapy, something targeting the body. What we’re learning more and more is that in many cases of chronic pain the problem lies in the mind or the brain. And we now have decades of research, both in neuroscience medicine and psychology, showing that there are a lot of changes that happen in the brain during chronic pain. In many cases, these can cause the pain to persist after an injury has healed.”

An important distinction that should be made when discussing chronic pain is that between the two types — primary and secondary.

“With secondary chronic pain, the pain is secondary to some medical problem or disease. With primary pain the pain is the primary problem, it is not secondary to anything else. What really is driving it are neuroplastic changes in the brain, and fear and avoidance. Fear is at the heart of chronic pain, so pain is a danger signal. The fundamental function of pain is to guide a person or animal away from things that are dangerous and when we perceive things to be dangerous that can amplify or even create this pain in our brains.”

Dr. Ashar likens primary chronic pain to a false alarm stuck in the “on” position. A technique called Pain Reprocessing Therapy or PRT, developed by pain psychologist Alan Gordon who was involved in the study seeks to silence the alarm.

“At the heart of PRT is learning to think and feel differently about your pain. What I mean by that is one: thinking differently about it, so understanding that the causes of the pain are non-dangerous, reversible brain changes — the pain is sort of a false alarm.

While it’s totally real, it’s due to these brain pathways that are firing that are not accurately reflecting the state of the body. The second piece of PRT is learning to feel differently about the pain, which what I mean by that is learning not to fear the pain and this happens on a more emotional level as well, but learning to change some of these automatic clenchings and tightening around the pain, learning to relax into it, because you know that it’s safe.” 

In the University of Colorado study, 151 participants suffering from chronic back pain underwent four weeks of treatment with PRT. The results were extraordinary.

“What we found was a really large drop in pain intensity. Two-thirds of people in the PRT condition were pain-free or nearly so, at post-treatment, as compared to less than 20% of controls. So existing psychological treatments like CBT (Cognitive Behavioral Therapy) or Acceptance and Commitment Therapy, generally aim to provide modest pain reductions and help people live more gracefully with their pain, they don’t really try to eliminate the pain. That’s one key thing that makes PRT different, is that PRT aims to eliminate the pain because it views the pain as being driven by reversible brain processes so it can be unlearned.”

Researchers were thrilled to find that the results held one year after treatment. Just what are the implications of these findings?

“What I believe we’ve been able to do in this study is take a similar treatment approach and show, in a well-conducted study, that it really works, that you really can resolve chronic pain with psychological treatment. The study shows that you can unlearn that pain and be pain-free, or nearly so.”

Thankfully, there are numerous therapists who are trained in PRT and can be readily found online. For researchers like Dr. Ashar, this study is a pivotal step towards changing the existing paradigm of how we approach pain and providing hard scientific evidence of the power of our minds to heal our bodies