Grant: CIHR Fellowship

Chronic back pain (CBP) is commonly disabling and very costly. Current treatments that focus on treating physical structures in the back itself are usually ineffective. This may be because changes in the nervous system and brain that often occur in people with CBP are responsible for the pain instead. Treatment guidelines for CBP recommend general exercise and physical activity but these treatments do not address brain changes. A further issue is that patients and clinicians are often unable to make effective decisions about treatment because they do not have the necessary understanding of these complex processes. This project integrates two exciting new areas of research. First, we now know that the brain changes that occur in chronic pain can be corrected and when they are, pain and disability are reduced. Second, we now know that giving people the required understanding to make effective health-related decisions improves their health. Building on the latest advances in these 2 areas, we will investigate if the combination of a new treatment ('training the brain') plus giving patients the resources to improve their health literacy, will decrease pain and disability in CBP. We will test this using the gold standard approach - a randomized controlled trial. Importantly, we are also using input from patients, clinicians, and stakeholders (eg, employers) to determine the best way to transfer and translate this knowledge into optimized clinical practice. This research could revolutionize how we treat CBP. If our theory is correct, it could lead to a reduction of the huge burden, on individuals and on society, of CBP. We expect to see improved rates of return to work and a large proportion of people resuming meaningful and productive lives. This project will have direct implications for the 1 in 5 Canadians who have a CBP problem that limits their life activities.