Psychological Options for Chronic Back/Neck Pain

(POWeR Trial)

This trial aims to determine the most effective treatment for veterans experiencing long-term neck or back pain. It compares three approaches: Pain Reprocessing Therapy (PRT), Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), and the care they are already receiving. Participants will be randomly assigned to one of these groups and will complete questionnaires about their pain and overall health. Veterans who have experienced moderate or severe back or neck pain for at least half of the past six months may be suitable candidates for this study. As an unphased trial, this study provides veterans with an opportunity to explore innovative therapies that could enhance their quality of life.

The trial information does not specify whether you need to stop taking your current medications. It seems like you can continue your usual care, which may include your current medications.

Previous studies on Pain Reprocessing Therapy (PRT) have shown promising safety results. Specifically, 98% of patients improved, with 66% becoming pain-free or nearly pain-free, and no major safety issues were reported. Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) is also well-tolerated. Research has shown it to be effective and safe, reducing pain and improving function. Participants have completed therapy sessions without major problems. Both therapies are non-invasive and manage pain through mental techniques instead of medication, making them generally safe options for those considering participation in such trials.¹²³⁴⁵

Researchers are excited about the treatments in this trial because they offer new psychological approaches to managing chronic back and neck pain. Pain Reprocessing Therapy (PRT) is unique because it focuses on retraining the brain's response to pain through education, mindfulness, and positive reinforcement, potentially breaking the pain-fear cycle and offering relief without medication. Cognitive Behavioral Therapy for Chronic Pain (CBT-CP), while already a leading approach, is also being tested to further validate and refine its effectiveness through structured sessions that teach skills like relaxation and cognitive coping. These therapies stand out from traditional medication or physical therapy options by addressing pain from a mental and emotional perspective, potentially leading to long-term benefits and improved quality of life.

Research has shown that Pain Reprocessing Therapy (PRT), one of the treatments in this trial, can be very effective for chronic pain. In one study, 98% of participants who tried PRT experienced improvement, and 66% were either pain-free or almost pain-free by the end. Some even reported complete recovery from back pain after completing PRT sessions.