Pain Reprocessing Therapy for Chronic Neck and Back Pain
(ESPRIT Trial)
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Colorado, Denver
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?The investigators are conducting a trial that evaluates the feasibility of telehealth group pain reprocessing therapy (PRT), with no comparison group, for the treatment of chronic back pain in a population of veterans. PRT is a psychotherapy for chronic pain that aims to help patients reconceptualize their pain as a non-dangerous signal. It has been shown to be effective in a previous RCT (n=151).
Do I have to stop taking my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to ask the trial coordinators for more details.
What data supports the idea that Pain Reprocessing Therapy for Chronic Neck and Back Pain is an effective treatment?
The available research shows that Pain Reprocessing Therapy (PRT) is effective for chronic back pain. In a study, two-thirds of patients who received PRT reported that their chronic back pain was either completely gone or almost gone. This suggests that PRT can significantly reduce or eliminate pain for many people. Compared to breathing re-education for chronic neck pain, which also showed improvement, PRT has a higher reported rate of pain elimination for back pain.
12345What safety data exists for Pain Reprocessing Therapy for chronic neck and back pain?
The provided research does not contain safety data for Pain Reprocessing Therapy (PRT) for chronic neck and back pain. The studies focus on platelet-rich plasma (PRP) and other regenerative treatments for low back pain, not PRT.
678910Is Pain Reprocessing Therapy (PRT) a promising treatment for chronic neck and back pain?
The provided research articles do not directly discuss Pain Reprocessing Therapy (PRT) for chronic neck and back pain. However, they highlight the importance of various manual therapies and rehabilitation techniques in managing such pain. This suggests that treatments focusing on muscle and spine health, like PRT, could be promising for reducing pain and improving function.
1112131415Eligibility Criteria
This trial is for veterans experiencing chronic neck or back pain. Participants should be able to attend therapy sessions via telehealth and must not have any conditions that would interfere with their ability to participate in psychological therapy.Inclusion Criteria
I have had back pain for at least 6 months, averaging at least 4 out of 10 in intensity.
I can attend at least 7 out of 8 online group meetings.
Access to safe living space, quiet room, reliable internet, and electronic device that can be used to attend telehealth therapy sessions
Exclusion Criteria
I have a known fracture or tumor in my spine.
I have been diagnosed with severe heart disease recently.
I have trouble controlling my bowel movements.
+10 more
Participant Groups
The study is testing Pain Reprocessing Therapy (PRT), a type of psychotherapy delivered through telehealth, designed to help patients view their chronic pain as non-threatening. There's no comparison group; all participants will receive PRT.
1Treatment groups
Experimental Treatment
Group I: Pain Reprocessing TherapyExperimental Treatment1 Intervention
Participants will participate in once weekly telehealth group pain reprocessing therapy. Sessions will last approximately 1 hour in length. Group size will be approximately 10 individuals.
Pain Reprocessing Therapy (PRT) is already approved in United States for the following indications:
🇺🇸 Approved in United States as Pain Reprocessing Therapy for:
- Chronic back pain
- Chronic neck pain
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Colorado - Anschutz Medical Campus VAAurora, CO
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Who Is Running the Clinical Trial?
University of Colorado, DenverLead Sponsor
VA Eastern Colorado Health Care SystemCollaborator
References
"I don't have chronic back pain anymore": Patient Experiences in Pain Reprocessing Therapy for Chronic Back Pain. [2023]In a recently published randomized controlled trial, two-thirds of the patients receiving a novel psychological treatment, pain reprocessing therapy (PRT), reported elimination or near-elimination of chronic back pain. The mechanisms of PRT and related treatments remain poorly understood but are hypothesized to center on pain reappraisal, fear reduction, and exposure-potentiated extinction. Here, we investigated treatment mechanisms from the participants' perspective. A sample of 32 adults with chronic back pain who received PRT completed semi-structured posttreatment interviews about their treatment experiences. The interviews were analyzed with multiphase thematic analysis. The analyses identified 3 major themes reflecting participants' understanding of how PRT led to pain relief: 1) reappraisal to reduce fear of pain, which included guiding participants to relate to pain as a helpful indicator, overcoming pain-related fear and avoidance, and reconceptualizing pain as a "sensation;" 2) the link between pain, emotions, and, stress, which included gaining insight into these connections and resolving difficult emotions; and 3) social connections, which included patient-provider alliance, therapist belief in the treatment model, and peer models of recovery from chronic pain. Our findings support the hypothesized mechanisms of PRT centered on pain reappraisal and fear reduction, but also highlight additional processes from the participants' perspective, including a focus on emotions and relationships. This study underscores the value of qualitative research methods in illuminating the mechanisms of novel pain therapies. PERSPECTIVE: This article presents participants' perspectives on their experience engaging in a novel psychotherapy for chronic pain, PRT. Through pain reappraisal, linking pain, emotions, and stress, and connecting with their therapist and peers, many participants reported an elimination or near-elimination of their chronic back pain with therapy.
Effects of breathing re-education on clinical outcomes in patients with nonspecific chronic neck pain. [2023]The present study evaluated the effectiveness of breathing re-education with routine physical therapy. This mixed method study was conducted at the District Headquarter Hospital Faisalabad, Faisalabad from April 2020 to July 2020. Fourteen participants (6men and 8 women) with chronic neck pain were recruited over a 16-week period and were equally divided into breathing re-education and routine physical therapy groups. The mean age of the patients was 38.48±5.92 years. Feasibility outcomes were recruitment, randomisation and retention rates of the participants. Clinical outcomes assessed for full trial were neck pain, cervical ROM, strength and endurance of neck muscles, quality of life and pulmonary functions. Outcomes were measured at baseline, fourth and eighth weeks. All the participants completed all the treatment sessions. No adverse events were reported. The breathing re-education group showed significant improvement in clinical outcomes. The results of this feasibility study provide supporting evidence for a future large-scale trial. Breathing re-education appears to be an effective treatment for chronic neck pain.
Patient-reported outcome measures in physical therapy practice for neck pain: an overview of reviews. [2023]Understanding which patient-reported outcome measures are being collected and utilized in clinical practice and research for patients with neck pain will help to inform recommendations for a core set of measures that provide value to patients and clinicians during diagnosis, clinical decision-making, goal setting and evaluation of responsiveness to treatment. Therefore, the aim of this study was to conduct a review of systematic reviews using a qualitative synthesis on the use of patient-reported outcome measures (PROMs) for patients presenting with neck pain to physical therapy.
Effect of manual soft tissue therapy on the pain in patients with chronic neck pain: A systematic review and meta-analysis. [2022]To systematically evaluate the impact of manual soft tissue therapy (MSTT) on the degree of pain in patients with chronic neck pain (CNP).
Patients' conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy. [2022]To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT).
Placebo Response Reduction and Accurate Pain Reporting Training Reduces Placebo Responses in a Clinical Trial on Chronic Low Back Pain: Results From a Comparison to the Literature. [2022]A literature review was conducted to compare placebo responses in a recent trial-which implemented an accurate pain reporting (APR) and placebo response reduction (PRR) training program-with placebo responses in similar previous trials in chronic lower back pain (CLBP) that did not use such training.
Plasma Rich in Growth Factors (PRGF) in the Treatment of Cervical and Lumbar Back Pain: A Retrospective Observational Clinical Study. [2021]Plasma rich in growth factors (PRGF) is a leukocyte-free platelet-rich plasma (PRP) that is an effective biological approach to tissue repair and has been demonstrated to significantly improve multiple conditions, including low back pain and degenerative disc pathology.
The Potency of Platelet-Rich Plasma for Chronic Low Back Pain: A Systematic Review and Metaanalysis of Randomized Controlled Trial. [2023]Low back pain is one of the leading causes of disability in the world. Regenerative medicine can be one of the novel treatment breakthroughs in patients with low back pain, yet its use is still debatable. We performed a systematic evaluation and meta-analysis to determine the efficacy of platelet-rich plasma (PRP) treatment for patients with chronic low back pain. Comprehensive database searches were performed in four databases. This study was conducted and reported based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses Guideline and registered to PROSPERO. We included and examined randomized controlled trials that looked into research employing PRP for patients with chronic low back pain. Outcomes of interest include clinical enhancement of pain, which is demonstrated in pain scores. Three studies were included comprising 138 patients with chronic low back pain. After 1, 3, and 6 months after injection, there was a substantial reduction in the pain score difference between the PRP and control groups, demonstrating PRP's superiority over the control group in the treatment of chronic low back pain. PRP injection significantly enhances chronic low back pain in the first, third, and sixth months after injection compared to controls.
Platelet-Rich Plasma for the Treatment of Low Back Pain: a Comprehensive Review. [2020]Back pain is a growing problem worldwide, incurring enormous economic costs and disability. Current treatment modalities often provide adequate relief but fail to address underlying conditions. Regenerative cellular modalities aim to restore anatomical function in degenerative conditions which may cause low back pain. Platelet-rich plasma (PRP) consists of an increased concentration of autologous platelets suspended in a small amount of plasma. PRP can be administered via injection or topically and is prepared using various techniques.
Modified prolotherapy by 5% dextrose: Two years experiences of a traditional and complementary medicine practice center in Turkey. [2022]Prolotherapy (PrT) is an increasingly popular regenerative injection treatment for the management of musculoskeletal injuries. The diagnostic injection is a method for selecting suitable patients to apply PrT using subcutaneous 5% dextrose solution.
Immediate effects of positional release therapy and manual trigger point release on neck pain and range of motion in computer users with upper trapezitis. [2022]The intent of the current study was to compare the immediate effects of positional release therapy (PRT) and manual trigger point release (MTpR) on neck range of motion and pain in upper trapezitis.
Comparison between high-velocity low-amplitude manipulation and muscle energy technique on pain and trunk neuromuscular postural control in male workers with chronic low back pain: A randomised crossover trial. [2023]A therapeutic recommendation for restoring function in individuals with chronic low back pain (CLBP) is manual therapy through manipulative spinal or muscle energy techniques.
Muscle Energy Technique in the Rehabilitative Treatment for Acute and Chronic Non-Specific Neck Pain: A Systematic Review. [2021]Non-specific neck pain (NNP) affects 30-50% of the general population, and it often leads to severe disability. Several manual therapy techniques are available to reduce pain and disability and to improve cervical range of motion and functional activities. Muscle Energy Technique (MET) showed more evidence for treating such a disorder. The aim of this current scientific literature analysis was to compare the clinical effects of MET with the other manual or rehabilitative treatments for non-specific acute and chronic neck pain.
[Medical training therapy in lumbar syndromes]. [2006]Chronic low back pain can be considered to be one of the most frequently treated and most costly diseases in modern industrial societies. Dysfunctions and imbalances of the spine-supporting muscles increase the risk of low back pain. Consequently preventive treatment and rehabilitation have to aim at preserving and restoring the full capacity of the spine-supporting muscles as well as training coordination and spine-friendly behaviour. In addition to various measures of pain therapy, physiotherapeutic treatment including neuro-physiotherapy, physical treatment (eg electrotherapy), balneotherapy and supportive behavioural training, medical rehabilitation therapy (MRT) ranks among the most effective ways of treating low back pain. MRT applies guidelines and methods of exercise methodology within medically indicated programmes of preventive treatment and rehabilitation. Various objectives of MRT are outlined with special regard to the stages of MRT treatment, emphasizing positive adaptation of the neuro-muscular system in the course of rehabilitation. Physicians are responsible for MRT diagnosis and control. Taking into account the base disorder and the progress of therapy physiotherapists and the physicians in charge determine MRT objectives and treatment strategies.
Medical training therapy in lumbar syndromes. [2019]Chronic low back pain can be considered to be one of the most frequently treated and most costly diseases in modern industrial societies. Dysfunctions and imbalances of the spine-supporting muscles increase the risk of low back pain. Consequently preventive treatment and rehabilitation have to aim at preserving and restoring the full capacity of the spine-supporting muscles as well as training coordination and spine-friendly behaviour. In addition to various measures of pain therapy, physiotherapeutic treatment including neuro-physiotherapy, physical treatment (eg electrotherapy), balneotherapy and supportive behavioural training, medical rehabilitation therapy (MRT) ranks among the most effective ways of treating low back pain. MRT applies guidelines and methods of exercise methodology within medically indicated programmes of preventive treatment and rehabilitation. Various objectives of MRT are outlined with special regard to the stages of MRT treatment, emphasizing positive adaptation of the neuro-muscular system in the course of rehabilitation. Physicians are responsible for MRT diagnosis and control. Taking into account the base disorder and the progress of therapy physiotherapists and the physicians in charge determine MRT objectives and treatment strategies.