Back pain is something a lot of people experience. It’s more common than the common cold and yet it remains difficult to treat. According to the Global Burden of Disease Study, it is the single leading cause of disability, worldwide. In the United States it is estimated that at least half of employed adults will report having back pain severe enough to miss work. In total over 80% of people will have a significant problem with back pain in their lives. Most causes of back pain are mechanical, that is, they are not caused by conditions like arthritis, cancer or serious injury. With growing numbers of patients becoming addicted to opioid pain medication, alternatives to treating back pain must be found.
In Australia, Dr. James McCauley has been studying low back pain for 12 years. He works as a research fellow and Group Leader at Neuroscience Research Australia, known as NeuRA. He is currently conducting a study on low back pain to see if relief can be found by using brain stimulation and re-training. Called, RESOLVE, the study involves 275 participants from the Sydney area, all of whom are experiencing low back pain that has lasted for more than 3 months. The study participants must have pain that is not related to any specific spinal pathology. Research shows that this kind of back pain, that does not result from injury or disease is the most difficult to treat.
The study will include two groups of patients, each group receiving a different treatment protocol, both of which will involve targeting treatment to the central nervous system in combination with traditional treatments targeted specifically to the back. While most lower back patients seek treatment such as surgery, pain medications and physical therapy that focus on the lower back, the goal of the RESOLVE program of treatment is to look past the back, to the central nervous system and the brain. Hopefully the CNS interventions will result in changing the way the brain processes pain signals from the back.
The two protocols include the same kind of traditional back therapy, with patients seeing a clinician one on one in weekly hour-long sessions. Their back pain will be assessed and documented and all participants will receive home care therapies to employ. Where the groups differ is in the method of CNS intervention. In one group, it will involve sensory training of how to respond to pain, motor imagery and visualization with feedback to show progress and functional motor training based on pain levels.
The other group will also receive the same number of one on one sessions and evaluation, but their CNS interventions will include transcranial directcurrent stimulation to the motor and pre-frontal cortices, cranial electrical stimulation, and low-intensity laser therapy and pulsed electromagnetic energy to the area of greatest pain. Both groups will undergo MRI screenings of the brain to see if any changes result.
In an interview with News 9 Australia, Dr. McCauley reported that early indications show that changes in the brain did occur in the patients in his study. He states, "You can see that certain areas of the brain appear to have less volume, so they have shrunk a bit. When certain areas of the brain have shrunk, the processing of information from a person's back is altered and the treatment seeks to return it to normal.” The video below from News 9 talks more about these hopeful results, check it out.