Sensorimotor Retraining For Chronic Back Pain: All About This New Treatment

Long-standing back pain is actually a problem of the nervous system, and it is modifiable, say researchers who have developed a new treatment of chronic back pain.

Back pain can occur due to different reasons, including injury, muscle strain, sleep disorders, older age, and certain medical conditions, like arthritis, disc problems, cancer, etc. If the pain continues for three months or longer, it is referred to as chronic back pain. Back pain can be frustrating. When rest and home remedies don't help, you may require medication, physical therapy, or both. The good news here is: Australian researchers have come up with an effective treatment for chronic back pain that targets the nervous system, unlike the traditional treatments the focuses on the back itself.

The new treatment called "sensorimotor retraining" focuses on how the back and the brain communicate and retrains them. It was tested in a randomised controlled trial conducted at UNSW Sydney and Neuroscience Research Australia (NeuRA) as well as some Australian and European universities.

Sensorimotor retraining offers long-term benefits

This new treatment method has shown a significant effect on pain intensity and disability in the trail. During the study at NeuRA, one group of participants undertook a 12-week course of sensorimotor retraining while the other group received a 12-week course of sham treatments.

The participants on sensorimotor retraining reported their backs felt better, their quality of life improved, and they were happier. Many of them were completely recovered and the effects remained even after one year, indicating long-term benefits of the treatment. The study results were reported in the Journal of the American Medical Association.

How sensorimotor retraining helps tackle back pain?

Sensorimotor retraining works by altering how people think about their body in pain, how they process sensory information from their back and how they move their back during activities, explained by Prof. James McAuley from UNSW's School of Health Sciences, and NeuRA.

Research has shown that the nervous system behaves differently in people with chronic back pain and those who suffered a lower back injury. The new treatment is based on this theory, Prof. McAuley said.

Prof. McAuley elaborated that when people with back pain are frequently told that their back is vulnerable and needs protecting, it tends to disrupt how the back and brain communicate, altering how they filter and interpret information from their back and move their back. Overtime, this reinforces the notion that their back is weak and less fit, he said adding that the new treatment they have developed aims to break this self-sustaining cycle.

The sensorimotor retraining aims to correct this dysfunction and normalise the communication between the back and the brain, by gradually retraining them.

Chronic back pain is actually a problem of the nervous system

Traditional treatment methods for chronic back pain, such as drugs, spinal manipulation, injections, surgery and spinal cord stimulators, mostly focus on fixing something in the back. However, the developers of the new treatment look at long-standing back pain as a modifiable problem of the nervous system rather than a disc, bone or muscle problem. Hence, they focus on how the body and the brain communicate and training them to improve this communication.

Prof. McAuley is hoping that the new treatment may be available in clinics in the next six to nine months. When it happens, it could be accessed at a cost similar to the therapies currently offered by trained physiotherapists, exercise physiologists and other clinicians.

Some medical conditions that can causes Back pain

The researchers noted that back pain is the number one cause of the Global Disability Burden for the last 30 years.

Older people are more likely to develop lower back pain due to age-related factors such as degenerative disk disease, muscle strain and ligament sprain or other factors such as previous occupation. For example, osteoarthritis (decreased bone mass) and spinal stenosis (the narrowing of the spinal cord) are known to be the common causes of lower back pain in senior citizens. But younger people can also suffer from back pain due to injuries, sedentary lifestyle, excess weight, strenuous physical exercise or due to some medical conditions. Below are some medical conditions that can cause chronic back pain:

Kidney problems: If you have kidney stones or kidney infection, your back pain could be one of its symptoms.

Cauda equina syndrome: It is a rare disorder that occurs when the nerve roots at the bottom of your spinal cord are compressed, which can happen due to an injury or herniated disk. This can cause low back pain, numbness or weakness in one or both legs, urinary retention, urinary incontinence, bowel retention, etc.

Spinal tumors: Back pain may also occur if you have a tumor on the spine that presses against a nerve.

Spinal Infections: Bacterial or fungal infections in or around your spine can also cause severe back pain, along with other symptoms such as difficulty urinating, weight loss, and fever.

Pelvic inflammatory disease: This is an infection of the female reproductive system most often caused by a sexually transmitted infection. Pain in the lower abdominal (belly), painful urination, Unusual or heavy vaginal discharge are common symptoms of PID. Many patients also complained of low backache.

Sleep disorders: People with sleep disorders like insomnia also report experiencing back pain. However, the association between these two conditions is not clear yet. Poor sleep can also exacerbate chronic back pain.

Shingles: It is a viral infection of the spinal nerves caused by the varicella-zoster virus. It is characterised by a painful skin rash with blisters that usually appears on one side of the face or body. Infected individuals may also experience back pain in the lumbar spine.

Autoimmune diseases: Back pain is also associated with autoimmune diseases like rheumatoid arthritis and lupus. Rheumatoid arthritis (RA) can affect people of any age, but it more likely to appear between ages 30 and 50 (middle age). In people with RA, the immune system may attack the synovial lining of the small joints of your spine, leading to back pain. Inflammation due to lupus can affect multiple organs including joints, skin, kidneys, blood cells, brain, heart and lungs.

COVID-19 infection: Back pain is also emerging as one of the post-Covid symptoms. Many recovered COVID patients have reported suffering from severe pain after recovering from the viral infection. Back pain and muscle pain are also common symptoms reported by patients in the early stages of the disease