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Answer to chronic back pain relief may not be in our backs but in our heads, CU Boulder research suggests

A walk in the park shouldn鈥檛 yield 15 years of pain, but it did for Lindsay Lord. When she was 10 years old, a kid on a swing crashed into her.听

鈥淚t knocked me out,鈥� Lord says. 鈥淚 remember I had a lollipop in my mouth.鈥�

When she came to, she began a long journey in search of relief for her lower back pain: orthopedists, chiropractors, physical therapists, spas, massages鈥攏ame a treatment, she tried it. In between the treatments, she faced a deluge of different diagnoses, but no respite for 15 years.听听听

That is, until she found help from an innovative lab at the University of Colorado Boulder.

The Cognitive and Affective Neuroscience Lab at CU Boulder is wrapping up the largest study of its kind for a way to treat chronic back pain (CBP)鈥攁 treatment without surgery or drugs鈥攂ut instead a change in the pain-sufferers鈥� thinking.听

And the results, while still unpublished, so far look promising with a 鈥渄ramatic reduction鈥� in chronic pain, according to Jonathan Ashar, a PhD candidate in psychology at CU Boulder and one of the researchers.听

If successful, this research could help many of the 261 million Americans who, according to the American Chiropractic Association, will face back pain at some time in their lives. What鈥檚 more, the research might ease the opioid crisis; earlier this year the American Medical Association reported that back pain is听one of the most common reasons听physicians prescribe opioids even though there鈥檚 no evidence that opioids actually treat the problem.听

In 2017, the study began welcoming Lord and others like her who may have 鈥渉ealed physically鈥� but continued to suffer CBP.听听听

鈥淥ftentimes, CBP persists even after the body has healed,鈥� Ashar says. 鈥淭his is about how the brain processes input from the body鈥攖he pain is essentially a false alarm in these cases and there鈥檚 no threat to the body.鈥�

Asher explains via an analogy: 鈥淚f there鈥檚 a fire (threat) at a school, the alarm rings (equal to pain in humans), firefighters come and put out the fire. The threat is gone, but sometimes the fire alarm keeps ringing (the pain continues). Over our evolution, we鈥檝e come to see that pain equals harm, but now we鈥檙e learning sometimes pain is a false signal, it鈥檚 just stuck in the on position.鈥澨�

In the study, researchers first examined CBP sufferers for physical reasons for their pain. If none was found, subjects began eight, 50-minute psychotherapy sessions over four weeks with Alan Gordon, a psychotherapist who specializes in treating chronic pain.听

Gordon used a relatively new treatment called pain reprocessing therapy (PRT). 鈥淭he premise is to teach the brain to interpret signals from the body accurately,鈥� Gordon says. 鈥淭he brain sees these signals as dangerous, but if we teach the brain that these signals aren鈥檛 actually dangerous, the brain flips off those signals, and the pain goes away.鈥澨�

That鈥檚 apparently what happened to Lord during her PRT sessions. 鈥淚 was able to wrap my mind around it and to realize there wasn鈥檛 a real reason for the pain,鈥� Lord says. To keep the pain at bay, she now tells herself, 鈥淵ou鈥檙e trippin鈥�; it鈥檚 not real.鈥�

Today, at age 27, Lord says the pain is 99 percent gone and she has kept it away, which was the case with most subjects, researchers say.

Both Gordon and Ashar say chronic pain sufferers should feel a renewed sense of hope.

鈥淭here鈥檚 a paradigm shift happening in science that鈥檚 being disseminated out to practitioners鈥攎uch of it is about the brain鈥攖reatments are still being worked out,听(but) in some cases psychological treatment can lead to complete reduction in pain,鈥� Ashar says. 鈥淏efore, that reduction was about 30 percent. So we believe chronic back pain can be significantly reduced.鈥�

Gordon adds the CU Boulder study and others related to brain-body treatments could be a tipping point for more acceptance and use of PRT.听

鈥淣ow there鈥檚 a lot of new research on the brain 鈥� and that can lead to us to start training an army of practitioners and start a certification program (for PRT),鈥� Gordon says. 鈥淚 believe 40 million of the 50 million people in chronic pain in this country don鈥檛 have to be in pain.鈥�

Gordon sees a day when people will bypass therapy and relieve their pain on their own. 鈥淭hey can deactivate the danger signals on their own鈥攍earn the techniques themselves without being in therapy,鈥� Gordon says. In fact, Gordon has just co-authored a book called听The Way Out, due out in 2020 and designed to help readers treat themselves.听

Ashar agrees people will likely be able to treat themselves but adds more research is needed. 鈥淩esearchers need to replicate our results in other settings, with other kinds of pain and with other therapists. If more research turns out favorable, work will begin to make treatment scalable.鈥�

As for Lord, she鈥檚 just grateful for having been in the study and learning a new way to think about pain.

鈥淚 think this definitely has potential to help people move through their pain 鈥� and enjoy their lives more,鈥� she says.听