Alleviating back pain by “retraining” the nervous system

Australian researchers are testing a treatment for chronic low back pain – this one doesn’t rely on drugs or traditional hands-on approaches such as spinal manipulation, injections, or surgery. The novel method called “sensorimotor retraining” challenges how people process sensory information from their back, instead of viewing back pain as only a physical problem.

In a trial jointly run by researchers at the University of New South Wales (UNSW) Sydney and Neuroscience Research Australia (NeuRA), some 300 participants were subjected to a course of sensorimotor retraining intended to address low back pain.

According to Professor James McAuley from UNSW’s School of Health Sciences, and NeuRA, participants reported longstanding, clinically meaningful effects on pain intensity and on disability at the end of the treatment period.

“People with back pain are often told their back is vulnerable and needs protecting. [Sensorimotor retraining] changes how we filter and interpret information from our back and how we move our back,” Professor McAuley said.

“People were happier, they reported their backs felt better and their quality of life was better. It also looks like these effects were sustained over the long term; twice as many people were completely recovered.”

The sensorimotor retraining incorporated research that showed the nervous system of people suffering from chronic back pain behaves differently than, say, those that acquired a recent injury to the lower back. This treatment also included specially-designed education modules and methods that corrects disruption within the nervous system which may lead to a self-sustaining cycle of pain and imprecise communication between the back and the brain.

In brief, the treatment aims to achieve three goals: to align patient understanding with the latest scientific understanding about what causes chronic back pain; to normalise the way the back and the brain communicate with each other; and to gradually retrain the body and the brain back to a normal protection setting and a resumption of usual activities.

While traditional therapies for chronic back pain focuses on fixing something in your back, injecting a disc, loosening up the joints, or strengthening the muscles, sensorimotor retraining looks at the system as a whole – what people think about their back, how the back and brain communicate, how the back is moved, as well as the fitness of the back.

The researchers are optimistic about rolling out a training package to bring this new treatment to clinics and have enlisted partner organisations to start that process. Once available, people suffering from chronic back pain should be able to access the new treatment at a similar cost to other therapies offered by trained physiotherapists, exercise physiologists, and other clinicians.

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