Chronic Lower Back Pain Overview (02:23)
More than 600 million people suffer lower back pain. Using an ultrasound, a doctor injects medication into the knot of bunched muscles in a man's back and the stiffness disappears. In Japan, 14 million people have long-term pain unresponsive to treatment.
New Back Pain Treatment (01:46)
Chronic lower back pain remedies focusing on the brain are gaining ground. Simple exercises relieve pain among 80% of employees at a Japanese nursing home.
Debilitating Spinal Mystery (03:37)
A former dancer, Megumi suffers chronic lower back pain and spends most of her time lying down. Spinal disc herniation, inflammation from injury, and stiffness cause back strain; more than half of Japanese patients experience pain persisting after treatment.
Back Pain and the Brain (02:52)
McGill University researchers found a thinner DLPFC in patients suffering chronic lower back pain. Inflammation establishes a pain processing circuit. When it subsides, the DLPFC normally orders the circuit to relax; if impaired, patients experience imaginary pain.
Imaginary Pain (03:04)
Megumi's DLPFC has low activity compared to those of healthy people. A fear of pain may play a role in DLPFC deterioration. Megumi is scared to leave her apartment.
Fear of Lower Back Pain (01:53)
Fear stresses the DLPFC. It weakens the DLPFC's ability to relax pain circuits, aggravating chronic pain or causing imaginary pain.
Visual Cognitive Back Pain Therapy (02:20)
Orthopedist Ko Matsudaira is alarmed by the low recovery rate of work-related back injuries. His treatment begins with showing patients videos to ease unnecessary fears about their condition. View a sample video.
Testing Visual Cognitive Back Pain Therapy (04:45)
Patients watch videos designed to ease fears about lower back pain. After ten days, Shuji Hoshino's pain is gone and he rides his bicycle. Decreasing fear relieves stress on the DLPFC and allows it to quiet the pain circuit—the treatment has mixed results among patients.
Cognitive Back Stretch Therapy (02:49)
Nursing home employees suffering chronic lower back pain try holding a posture for 3 seconds. Arching backward helps eliminate fear and regain confidence.
Cognitive Back Stretch Therapy Results (03:43)
Kazuhiko Arai and Yumi Ishiyama suffer chronic lower back pain. By practicing an arching posture daily, they increased their range of motion and report less pain. The exercise helps diminish fear of pain and helps the DLPFC regain function.
Addressing Persistent Fear of Back Pain (04:31)
Watching cognitive therapy videos or arching the back "trains" the brain not to feel pain. An Australian program uses cognitive behavioral therapy to treat people failed by surgery and medication. Brielle Hughes has suffered for 9 months, and could not walk when she began.
Cognitive Behavioral Therapy for Back Pain (03:52)
An Australian program instructs participants to perform exercises to show them that moving is not painful. Documenting each set shows their improvement, helping build confidence. Together with counseling, this approach helps participants manage their pain.
Cognitive Behavioral Therapy in Japan (02:33)
Cognitive behavioral therapy increases DLPFC activity in people's brains to reduce their fear of back pain. Since 2012, it has been included in Japanese guidelines for treating back pain.
Back Pain Awareness Campaign (03:23)
The Australian government shows videos on easing fears of back pain in cafes and runs ads on TV. Rather than doing x-rays immediately, doctors enter patient data in a program showing diagnostic choices; most recommend resuming activity. Chronic back pain has decreased nationally.
Building Confidence to Reduce Chronic Pain (04:41)
Megumi receives cognitive behavioral therapy to reduce her fear of pain. Her doctor suggests she play the piano daily, gradually increasing duration. An estimated 600 million people suffer lower back pain worldwide; studies show their pain could be imaginary.
Credits: Back Pain and the Brain: Medical Revolution (00:30)
Credits: Back Pain and the Brain: Medical Revolution
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