亚美棋牌 and NeuRA researchers have created an effective therapy for chronic pain that reduces pain intensity by focusing on emotional regulation.
A new study led by 亚美棋牌 and Neuroscience Research Australia (NeuRA) shows that targeting emotional processing is key to treating and managing chronic pain.
The study is based on a randomised controlled trial led by Professor Sylvia Gustin and Dr Nell Norman-Nott, both from 亚美棋牌 and NeuRA. Along with a team at NeuRA鈥檚 Centre for Pain IMPACT, they today in JAMA Network Open.
The trial showed that enhancing the brain鈥檚 capacity for emotional processing through therapeutic intervention is an effective approach to managing chronic pain.
鈥淏y changing how we manage emotions, it is possible to change the experience of pain itself,鈥 Prof. Gustin says. 鈥淭his is not just a temporary relief but a potential long-term improvement in quality of life for those affected by chronic pain.鈥
Prof. Gustin and Dr Norman-Nott developed Pain and Emotion Therapy 鈥 a novel and emerging eHealth intervention. The therapy aims to retrain the brain to more easily process emotions by improving an individual's ability to deescalate negative emotions and enhance positive ones.
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The trial took place from March 2023 to September 2024 and focused on the experiences of 89 people with chronic pain. The authors say the results could lead to new ways of treating chronic pain, emphasising the profound impact of emotional health on physical wellbeing.
The online therapy, made available through the trial, is the first of its kind, delivered through eight group-based therapist-guided sessions by video conference across Australia. Participants also used an app and handbook for self-learning. The control group continued their usual treatment.
Prof. Gustin says those who received the new treatment reported better emotional regulation as well as pain reduction equal to a 10-point decrease on a 100-point scale for pain intensity within a six-month follow up.
"This shows not only a clinical improvement, but one that makes a noticeable difference in the daily lives of the people affected," she says.
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Understanding chronic pain
Chronic pain, defined as pain lasting longer than three months, affects around 30% of people globally. The economic costs are to be higher than that of heart disease, cancer and diabetes combined.
Declining mental health is also widespread, with up to 80% of people with chronic pain experiencing and . In addition, suicide rates are than those of the general population.
鈥淎 key factor in disease progression is the inability to regulate negative emotions,鈥 Prof. Gustin says. 鈥淭his is disrupted by the impact of persistent pain on the brain鈥檚 emotional circuitry. The resulting emotion dysregulation is an ill-understood and undertreated aspect of chronic pain, which we addressed in this trial.鈥
Study participant Jabez Allies has had chronic back pain for 10 years. She says chronic pain affects her emotions.
鈥淚t makes me feel more worried, moody and frustrated, which in turn affects my pain. The more negative emotions I have, the worse my pain is, and vice versa,鈥 she says.
Prof. Gustin says this cycle of worsening pain and increasing negative emotions is a common presentation.
鈥淚t shows us that chronic pain really does have a considerable effect on how people feel and the level of pain they experience.鈥
A boost to traditional treatments
Dr Norman Nott says that in the past 50鈥60 years, the model of chronic pain has shifted focus.
鈥淲e鈥檝e gone from purely medical and biological approaches to a more holistic treatment model that includes addressing social and psychological experiences,鈥 Dr Norman Nott says.
She says while prescription and non-prescription pain medications continue to play an important role in treatment, they have limitations.
鈥淚鈥檓 thinking particularly of side effects and diminishing efficacy over time. Opioids, specifically, present considerable issues with dependency and declining effectiveness.鈥
She says, 鈥渢hough psychological therapies come with few side effects, we know there are still improvements needed, particularly to address the key mental health concerns of people with chronic pain, such as identifying and expressing emotions, and calming down emotional reactiveness.
鈥淭he focus on training for emotional regulation appears to be the missing piece of the jigsaw puzzle of chronic pain treatment.
鈥淭his is why we created this therapy 鈥 to focus on emotion processing by improving how people manage their emotions.鈥
Richard Beaumont is a participant who has had cancer pain and chronic lower back pain for 11 years. He says he frequently gets pain that reaches an eight or nine out of 10.
鈥淎fter receiving Pain and Emotion Therapy I can bring this right down to a four or five just by calming the farm,鈥 he says.
After receiving Pain and Emotion Therapy I can bring this right down to a four or five just by calming the farm.
Targeting the emotional brain
鈥淧revious research shows us that the brain can be trained to identify negative emotions and regulate them,鈥 Prof. Gustin says. 鈥淲ith this trial we can now see that engaging emotion regulation skills can reduce the intensity of pain and improve several other factors such as depression, anxiety and sleep problems.鈥
Dr Norman-Nott says this new therapy works by teaching participants that we need emotions in our lives.
鈥淥ften when we live with chronic pain for many years, negative emotions get pushed down and positive emotions become harder to identify,鈥 Dr Norman-Nott says.
鈥淲e focus on helping to identify and bring up those negative emotions so that they can be acknowledged and resolved 鈥撎齱hile also realising the potential positive aspects of life and setting goals for the future.鈥
Accessible treatment for all
The accessibility of psychological treatment for chronic pain is a听听of governmental concern.
The progression and management of the disease are further aggravated by long wait times and limited healthcare services outside of capital cities.
鈥淥ur online treatment delivery reduced barriers by making it accessible to those who struggle with mobility, social anxiety, or physical exhaustion from travelling to in-person appointments,鈥 Dr Norman-Nott says.
鈥淚t enabled them to participate from every state in Australia, including many from remote and regional locations.
鈥淧articipants attended the online sessions from their homes, or wherever it was comfortable for them, so they could train their emotion regulation skills when it suited them via the customised app and workbook.鈥
The next step for rolling out听Pain and Emotion Therapy听is a larger clinical trial supported by the听, due to start in 2026.
The researchers are now听听to register their interest in the trial.
鈥淭he results we've seen so far are a big improvement in our understanding of chronic pain, showing how important it is to treat both the body and emotions together,鈥 says Prof. Gustin.
