New paradigm in chronic pain treatment may relieve suffering for millions

It’s the bane of every pain specialist’s life, the chronic pain patient who is simply not getting relief from any of the treatments he or she has tried. It’s not the doctor’s fault, because according to a meta-analysis published in the journal “Pain”, most chronic pain patients are not being helped, by anything, including even the opioids, which are now recognised as increasing pain sensitivity, as well as being responsible for addiction and even deaths.

It’s estimated that around 1 in 5 people suffer from chronic pain, meaning that most of the 1.5 billion sufferers on the planet continue to live in misery every day, unable to contribute to their families or communities in the way they’d wish. Human misery aside, the financial cost of unresolved chronic pain is in the hundreds of billions of dollars annually.

The stumbling block to real advances in the field of chronic pain has been the misconception that chronic pain is just another type of acute pain, and so up until now most research has focussed on the search for new and better analgesics, to no avail.

In fact we now know that apart from terrible suffering, acute pain and chronic pain bear little resemblance. For example, unlike for acute pain, analgesics don’t work very well for most people with chronic pain. Also unlike acute pain, with chronic pain there is zero correlation between the pain, and MRI or X-ray diagnostics. Likewise when surgery and sham surgery are used for chronic pain, we see no difference in outcomes between the two groups. Finally, fMRI shows unequivocally that chronic pain almost always involves conditioned activity in the brain, primarily in the amygdala region, the area responsible for triggering emotions such as anger, or fear.

The latter discovery is the key to the entire puzzle says clinical researcher Christine Sutherland. “We found that when we used a particular extinction strategy called MDR (multi-sensory disruption of reconsolidation of conditioned responses) targeted at permanently extinguishing the conditioned activity responsible for pain signalling, it was like flicking an off switch on the pain, and it was permanent.”

Ms Sutherland reported that the results seemed to hold long term, with study participants experiencing continued absence of pain 2 years later.

Professor of neuroscience and psychiatry, Dr Yves de Koninck, agrees with this theory and treatment approach, although he advocates for an invasive procedure to achieve extinction, referring to the process as “recall and erase”.

A short webinar for psychologists, explaining the theoretical basis and methodology of the non-invasive new treatment, and providing an opportunity to learn the MDR strategy, is at https://www.mdrtherapy.org/mdr-webinar-for-psychologists.

Chronic pain patients may like to download the free pre-reading which explains the MDR chronic pain treatment process, at https://www.lifeworkspainclinic.com/mdr-pre-reading.