Stanford Study on Pain and the Brain Underway

Stanford Study on Pain and the Brain Underway

By Ed Coghlan.

An interesting study on back pain and the brain is underway at Stanford, to help researchers understand how pain psychology classes and health education classes may improve back pain. It’s part of a $4 million National Institutes of Health clinical trial.

Editor’s Note – I’ve suffered from low back pain for four decades and know well how when an episode of pain flares up it impacts my mood, not to mention my ability to function, so I find this study particularly interesting.

Stanford’s Beth Darnall PhD and Sean Mackey MD, PhD are leading the study which they aim to better understand and more effectively treat chronic pain.

231 people with chronic law back pain who have a self-reported negative pain mindset are being enrolled in the study and randomized to treatment.  Some will undergo an eight-week Cognitive behavioral therapy (CBT) treatment that helps patients understand the thoughts and feelings that influence behaviors.

Others may receive Dr. Darnall’s single-session pain-relief mindset class, which has shown promise for helping people develop adaptive brain entrainment skills – including calming the nervous system, developing ways to self-soothe when in pain, and steering the brain towards patterns of thoughts that are shown to confer pain relief.

There is growing awareness and data to suggest that negative pain mindset factors alter brain functioning and even the structure of the brain. But effective psychological treatment can reverse these negative impacts and give people back a critical level of control over their persistent pain.

Researchers hope to show that Dr. Darnall’s class can effectively reduce negative pain mindset (“pain catastrophizing”) and equip participants with the skills to better control their own experience, and reduce pain and suffering. A single session pain-relief mindset class would help improve access to psychological treatment for pain.

Study participants must be between 18 and 70 years old, fluent in English and able to attend a screening session and up to eight sessions at the Stanford Neuroscience and Pain Lab in Palo Alto, California.

Even when you have low back pain that is being medically treated, it helps to understand the psychological factors that impact your pain — and your brain. It also helps to know what you can do about this. The study is funded by the NIH National Center for Complementary and Integrative Health (NCCIH).

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Authored by: Ed Coghlan

There are 15 comments for this article
  1. Sarah at 4:28 pm

    I think as stated above why not use real chronic pain patients who deal with pain 24hrs day. I have done pain therapy and understand the psychology of pain and accept this is my life. Do I still need pain medications yes am I receiving the right medication for my pain no. I fear everyday to even ask about a different pain medication that I feel will help me to to live a better quality of life. Shouldn’t we as patients of an illness we didn’t ask for be able to take medications to live the best life we can. Pain in itself is also very damaging to the organs and mental health. Is it right to scare caring doctor’s into leaving their patients in pain. Chronic pain patients do not use their pain meds to get high they use them to live the best life they possibly can knowing that they can never go back to the person they used to be but want to live. To get dressed, to clean their homes, to make dinner for their family’s and have just a piece of their lives back. Why is it that we are not being heard? Not as addicts just a patient trying to have some quality of life. Is fair to categorize patients like myself with a drug addict? Let’s talk to people like myself let’s actually listen and have some empathy and understand their stories of dealing with pain everyday pain they never ask for pain that changed their lives forever.

  2. Cat at 6:54 pm

    These heartless thugs are taking facts not in evidence-you can think your debilitating pain away- and forcing them down are throats as reality.

  3. Barbara W at 12:48 pm

    I totally agree about giving us pain relief for flare ups , as in the present climate doctors are afraid to subscribe more! 12 years ago I was told that doctor someday will go into the brain & disconnect the impulses to feel pain each for his own area. That will cure the problem! They do perform those surgerys now but only when waivers are signed & the patient is so bad he doesn’t care if he dies. I understand that they could immobilize vital Singnals accidentally that is why it is not done for general public. Not to speak of the costt!!!!

  4. Kathy C at 10:09 am

    These types of “Studies” are designed to deceive. They conflate “Self Reported Back Pain’ with Long Tern Chronic Pain. They don’t make any distinction between people who experience occasional discomfort from sitting at a desk, or occasional sports activity, and people with structural problems, injuries, and multiple surgeries. Of course they don’t include those characteristics in their “Studies.” They also make some really unfounded statements, proving they are already biased.
    They choose to “Study” this “Negative Mindset” and by doing this they re affirm their already biased Ideology. There is very likely a Negative thoughts, and pain feedback loop, and in cases of occasional “back Pain” might interfere with activities cause less activity and more pain, creating a negative spiral, but it has little to do with real or imagined “Catastrophization.”
    It is really clever what they are doing here in order to Market “Complimentary Medicine,” or Pseudo Science. There won’t be any long term follow up, by design. The Insurance Companies will be happy to fund this kind of “Research.” The results of these biased “Studies” will be useful in discrediting Injured people. These Studies don’t have to be scientific or Evidence Based, they are designed to mislead, deceive and spread Pseudo Science. It is not about Facts and Science anymore it is all about belief. What they are doing here is incredibly Un Ethical, and the results will be used to spread more misinformation. Just becsue they got funding to “Study” this topic, does not mean it is based on Science or there is any factual evidence for their “Study.”

  5. Linda at 7:44 am

    Why not ask the folks in chronic pain who have already received CBT. The study seems like not only wasted money, but has the potential to be swayed in a proof-positive direction, because if it “shows” promise on paper, the more money the government will hand feed to anything that falls in line with its current positions on narcotic pain medications.

    The government wants to be able to show on paper that CBT works on actual pain.

    They can paint a broad stroke with that CBT brush, if they get it via a study. It’ll be the cure-all to any and all pain so they can eliminate opiods altogether.

    I’m against it. I’ve been through CBT, more than once. A very lengthy process when going to a therapist. Homework Homework Homework. Followup
    Followup
    Followup
    Therapy
    Therapy
    Therapy
    Until you’ve had it yourself, because the therapist will never cut you loose on their own. They’re happy to keep receiving money forever off of each patient.

    CBT might have helped me with something completely different, had it been offered to me 30 years ago. That something else would have been, maybe, to teach me how to cope with the change of going from a non pain person to a person living in pain. This has nothing whatsoever to do with actual pain. It didn’t for me.

    And if for some reason CBT is different now, it still IS WHAT IT IS. It’s not pain therapy! It’s COPING therapy!
    I want to be treated like more than a wild animal, I want to be treated like a highly suffering human being.

    I also want everyone to stop telling me How to feel, What I should feel, How to act, how Not to act, and What to Say and What Not To Say.

    I am a woman in severe pain, who is living this nightmare alongside of you too. This is my only place that allows me to Shout Out to the world, even though it’s just the world here at national pain report..

  6. Michael G Langley, MD at 7:44 am

    Pain is not my problem. Suffering is! That is why this helps. But, it is not a cure! If I broke my neck and severed my spinal cord, I would no longer have pain! Maybe that us because the brain is where all of the suffering is perceived! The lack of compassion leads to a lack of complete treatment of the suffering of the patient. That lack is a big part of what medicine has become. Add to it, physicians that are ignorant of the mind body connection, the failure is almost complete!

  7. Cindy J Deim at 7:39 pm

    I just wanted to remind people about Opioid Policy Steering Committee: Prescribing Intervention-Exploring a Strategy for Implementation; Public Hearing; Request for Commentshttps://www.federalregister.gov/documents/2017/12/13/2017-26785/opioid-policy-steering-committee-prescribing-intervention-exploring-a-strategy-for-implementation#p-4
    Please write them and tell them your story. It’s important to us all.
    Each state is also doing it as well. I’m in coloradohttps://www.colorado.gov/pacific/dora/Medical_News
    The state one has to be in by tomorrow.
    this is one of those things that everyone can do to help with pain medication. We all wonder what we can do, this is a big one.

  8. Dennis Brassaw at 4:25 pm

    28′ fall ’92, T12, L1, L2 compression fXs, broken sternum from hyper-flex spine, mouthful broken teeth from knee impact on chin. FDA approved(1996) L5-S1Ray cage fusion surgery in ’99 that was determined to create an unstable spine(2001/2002) and no longer done, created 18 months post-surgery hell.

    Fusion failed in Sept ’07 and not diagnosed and repaired till May ’13 results in chronic pain that would’ve killed me if not for the fact that I’m ADHD and I’m now dealing with the stupidity crisis over pain relief from opiods. Had mine yanked in May ’17 due to my own stupidity of admitting I tried pot to get sleep to no avail…oops, broke pain contract, your done!

  9. Jill at 4:10 pm

    I’m a big believer in CBT and a positive mindset helping with pain that is mild to moderate. But these methods at least for me cannot help with severe pain and flare ups. Will be interested in their findings.

  10. Ibn at 1:48 pm

    How about those that have surgeries and suffer cotinuous pain on a scale form “6”; to “:8” continuoosly, yearly or for decades?

  11. Steven Smith at 1:20 pm

    I read with interest your article and it may well help someone just starting with pain but for someone who has suffered years and possibly decades this is a poor replacement for a medication therapy that has been working for a very long time. Someone just starting out with a problem it may well be a big help. You severe pain patients
    KNOW what I mean. A particular problem of conforming to an arbitrary system set up by our ill-advised government won’t stop many abusers but it certainly will sadly eliminate a lot of patients.

  12. CathyM at 8:40 am

    Oh, how I wish they would study how depth psychology would help those with back (or other chronic) pain! It’s a rule that you only study what you can see, or count, or isolate – so CBT is being touted because it’s so damn simplistic that it can be measured! And then they claim it’s better than longterm therapy. If I won a lottery (not likely since I don’t buy tickets) I’d fund a study of psychotherapy’s effects over 5-10 years… I’m guessing it would be much bigger, for those who are interested in getting to the root of their unconscious blocks. Because I can see how early trauma might increase the odds of physical pain later in life, but CBT isn’t gonna do bupkis to change what’s needed to change. And then the patient feels guilty because “they aren’t doing it right.” IMO.

  13. Danny at 4:54 am

    The phrase “Pain catastrophizing” itself really frustrates me. Oh, how I wish these two doctors were experiencing the pain that started in me yesterday and is at least a #9 this morning. It’s not back pain, but the phrase isn’t limited to back pain, as I understand it. Not a minute of sleep last night and I spent most of the night doing biofeedback and relaxation techniques that sometimes helps me to sleep a little. Not last night/this morning. I sincerely hope they discover something that helps people, though.

  14. Doc Anonymous at 3:21 am

    The results of this study will be interesting. But let me point out one other thing that sorely needs study, and you mentioned it yourself, Mr. Coghlan. You stated that you “know well” the impact of a “flare up”. Most of us who have had chronic spinal pain would agree with you.

    I submit that the medical profession simply does not recognize the existence of these flare ups, and it appears that the study cited above is looking only at the stable baseline level of spinal pain. It would be more important to identify the impact of “flare ups” on the brain. Perhaps someone somewhere will have sufficient understanding of chronic pain to undertake a follow up study on the impact of flare ups on the brain,

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