Medical Moment: A new tool to relieve chronic back pain

Published: Sep. 14, 2022 at 5:34 PM EDT
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(WNDU) - Nearly 16 million Americans suffer from chronic back pain.

More than anything, it’s stubborn. In some cases, not even surgery can help. But now a tiny implant is giving some people their lives back.

64-year-old James Moharter spent 17 years with excruciating back pain.

“We got hit from behind, sent into some other vehicles, five cars rolled and rolled,” Moharter recalled.

Three back surgeries provided no relief. He was on pain medication 24 hours a day, including morphine, oxycodone, and fentanyl.

“People would be pinning notes on me cuz they came to the house and couldn’t wake me up,” Moharter said.

James told his doctors he wanted to find another way to manage the pain. Doctors at Duke suggested this, a spinal stimulator.

“It’s just kind of another tool in your pocket that a patient can use to help decrease their pain,” explained Peter Yi, an anesthesiologist at Duke Health.

Surgeons implant the device in the lower back or buttocks. The device targets the nerves that process pain. The patient controls the strength of the signal with a remote.

“I have a wireless charger that I have to hold against my hip every couple weeks to charge me up a little bit,” Moharter said.

James said he barely needs any medication at all now.

“Couldn’t do this before,” Moharter said. “I’m trying to gain back things that I thought I never would do again.”

And for the first time in years, James is going camping.

Researchers have created a type of treatment called pain reprocessing therapy (PRT) to help the brain “unlearn” the kind of pain associated with chronic back pain.

PRT helps people learn to recognize pain signals sent to the brain as less threatening. Therapists help patients do painful movements all the while helping them re-evaluate the sensations they experience.

A team at the University of Colorado, led by Yoni Ashar, MD (now at Weill Cornell Medical College) and Tor Wager, MD (now at Dartmouth College) enrolled 151 people in the first clinical trial with mild to moderate chronic back pain for which no physical cause could be found.

One of three treatments was given: four weeks of intensive PRT, a placebo injection of saline into the back, or a continuation of care as usual. After 4 weeks of PRT, 66 percent of people who underwent the therapy reported being pain-free or nearly pain-free.

In contrast, only 20 percent of people who received placebo injections and 10 percent of those receiving usual care reported similar improvements. The reductions in pain after PRT were largely maintained a year after treatment.

“This treatment is based on the premise that the brain can generate pain in the absence of injury or after an injury has healed, and that people can unlearn that pain. Our study shows it works,” Dr. Ashar said.