Research Seeks to Better Identify Chronic Back Pain Treatments

While chiropractic treatments help reduce back pain for many people, they don’t always work in every case. With surgery now considered a treatment of last resort in most cases, patients will turn to other options. New research suggests that digital technology can identify what treatments work best for an individual suffering from chronic back pain by studying changes in the brain.

Acceptance and Commitment Therapy

MRI of the Brain

Rachel Smallwood and her team from the University of Texas-San Antonio evaluated 25 opioid-addicted patients with chronic lower back pain. The participants underwent functional MRI of the brain while at rest and while being subjected to pain. The patients also attended eight sessions of Acceptance and Commitment Therapy (ACT), a form of psychotherapy. Imaging showed changes in brain activity following ACT therapy, with patients responding less to pain post-treatment.

“Clinically, our findings imply that these regions and connections between regions are likely some of the key regions that are altered in patients with chronic low back pain and opioid addiction,” she told Medscape Medical News. “If we can find a common predictor in the patients that responded best to the treatment, in combination with knowing what the treatment affects in the brain, it would allow us to predict what treatment options would be best for an individual, rather than trial and error with many treatments.”

The results offer important clues to identifying which parts of the brain are affected by the therapy and which are affected by the addiction.

Richard E. Harris, Ph.D., assistant professor in the Chronic Pain and Fatigue Research Center in the Department of Anesthesiology at the University of Michigan-Ann Arbor, agrees that “these findings are important for the field of pain treatment. It is not known how interventions like ACT work, or for most pain treatments for that matter, and finding that ACT acts on brain network properties is important.”

Harris adds: “The thinking in the field is that this type of neuroimaging procedure may at some time be able to guide effective pain treatment targeted for specific individuals. Knowing what the underlying pathology is is important, as this should guide treatment. This study focused on low back pain, but the findings may be generalized to other pain conditions such as fibromyalgia.”

Theramine vs. Anti-Infammatory Drugs

MRI of the Brain

One new treatment that has shown promise for back pain is Theramine, which in trials was reported to be more effective than ibuprofen in reducing low back pain while also showing a notable decrease in inflammation. The results of the research are available at

Cardiologist William Shell explains, “The overuse of NSAIDs is a growing concern among physicians and patients due to the potential stomach bleeding, heart attacks, and strokes associated with every NSAID product.” Non-steroidal anti-inflammatory drugs include aspirin, Aleve, and ibuprofen. Shell adds: “The American Geriatric Society recommends restricting or eliminating the use of NSAIDs in patients 65 years of age and older due to their potential risks. The results of this and previous studies confirm that Theramine can be used as a safe and effective alternative to NSAIDs for patients suffering from chronic pain.”

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