Wednesday, January 30, 2008

Getting a handle on Back Pain

Here are some good, written-for-the-public, articles on the old topic of back pain and a new high-tech twist on its alleviation. Article 1 is by Jonah Lehrer, author of the blog Frontal Cortex and an editor for Seed Magazine: The Psychology of Back Pain.

The article uses the word "mind"(Christof Koch would probably not approve); however, the gist of it is that if a person with chronic low back pain can access a way to visualize the regions of the brain involved in and perpetuating/fueling the "central sensitization" of the body zone involved, i.e., viewing their own brain on an fMRI screen, they can learn to reduce the back pain in a top-down manner. Excerpt from the last page of the article:
"Christopher deCharms, PhD, a lead author on Dr. Mackey’s paper, is trying to take this therapeutic approach mainstream. He has started a company called Omneuron, which makes the experimental treatment available to a wider audience. A standard session goes like this: A patient lies in a brain scanner while experiencing pain, and he watches as his brain flares up in agony. He sees the smear of neural activity that makes him suffer. Then, with the help of a trained therapist, the patient learns how to consciously turn off the specific brain areas that correlate with the chronic pain. After a few sessions, the awful symptoms begin to fade away. The pain is no longer permanent. It’s a real-world example of mind over matter."

Another general-reader article, called Seeing Your Pain, by Emily Singer, discusses Omneuron's work in a bit more detail.

I found these two articles linked into a thread called "The Psychology of Back Pain", at

Both these articles but especially the second (all the way through) emphasize doing something with basic visualization;

1. Turn attention inward (in this case, with the help of a huge expensive MRI visual feedback machine, which provides an outside, visible "fixation" point; associative "learning" takes place)

2. Create a visible "thought object" (as per Antonio Damasio) to hold in one's attention, in this case a visual image that represents one's "pain" (in this case, it's a red spot on a screen flickering in a part of the brain that brain research has identified as being associated with persistent pain, therefore as close to "real", as closely associated as it's possible to get, probably - boosting the all important "trust" factor)

3. Find ways to "deconstruct" the now-'visible' "thought object", the visualization of the pain, the "source" of it.

I guess this works (finally) for those who can't just go ahead and do a facsimile of this on their own. In fact, I wonder if one could find correlations between low back pain and lack of imagination? Image-ination? Ability to form visual images?

We already know that the brain can't tell the difference between something "real" and something "illusory". It will respond to a sufficiently convincing image and downregulate pain successfully, as Ramachandran's mirror work for phantom limb pain has shown.

MRIs are still pretty expensive to use as feedback devices. As Ian S. pointed out in the thread,
"sitting still and learning to meditate costs $0... I think the interventions are interesting but fit in with the culture of high tech solutions to what are low tech approaches (paying attention / learning to take responsibility / reducing threat )."

No comments: