Changing Beliefs, Changing Pain

Chronic back pain (CBP), the most common type of chronic pain, needs better treatment. Does psychological treatment, or pain reprocessing therapy (PRT), help? “PRT seeks to promote patients’ reconceptualization of primary (nociplastic) chronic pain as a brain-generated false alarm.” A study published in JAMA Psychiatry reported a trial of adults randomized to either 1) PRT over 4 weeks, with 1 physician telehealth and 8 psychological treatment sessions; 2) placebo, receiving a back saline injection; or 3) usual, ongoing care. Of 151 total participants, the following were painfree or nearly painfree:

• 33 of 50 of the PRT group (66%), with a pain score of 1.18
• 10 of 51 of the placebo group (20%), with a pain score of 2.84
• 5 of 50 of the usual care group (10%), with a pain score of 3.13

During the 1 hour therapy sessions, patients in the PRT group learned to reappraise pain sensations, identify threats/emotions that might amplify pain, and increase positive emotions. The study concluded that “Psychological treatment centered on changing patients’ beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with CBP” and “Overall, our findings raise key possibilities about the nature and treatment of primary CBP. Changing fear- and avoidance-inducing beliefs about the causes and threat value of pain may provide substantial, durable pain relief for people with primary CBP.”

 

Read the journal article.

Other Categories:

• central nervous system (CNS)

• chronic pain

• clinical trials

• cognitive behavioral therapy (CBT)

• Mindfulness

• psychology

• Telehealth/telemedicine