The Research on Neurofeedback for Chronic Pain

Have you ever been in chronic pain? What differentiates acute pain from chronic pain? Chronic pain persists after treatment has been provided. The pain can last from weeks to years and may be the cause of serious life consequences, including employment trouble, relationship issues, and mental health problems. The CDC estimates that 20% of American adults suffer from chronic pain. So, if you are reading this article, there is a 1 in 5 chance that you have suffered or are suffering from chronic pain.

What are the most common treatments for chronic pain? Acetaminophen for minor pain. Cognitive behavioral therapy is another choice. If the pain is severe, then opioids like hydrocodone, oxycodone, and morphine are the drugs of choice. All too often, these drugs are offered in moderate pain as well. Medication, unfortunately, may have severe health consequences, including addiction.

So, what’s to be done? Well, it turns out that chronic pain, especially the idiopathic kind (cause undefined), is not a joint, bone or tissue problem, it’s a brain problem. So, the treatment of choice should be a modality that addresses the brain, such as neurofeedback. Not just any neurofeedback but Infraslow (ISF) neurofeedback as it has been subjected to research and found to help reduce chronic pain. Moreover, unlike other forms of neurofeedback, ISF sLORETA can direct treatment to precise areas and regions in the brain within the frequency parameters determined by pain research to be helpful.

If you find the above statement a bit perplexing, don’t worry; a little more explanation may be in order to truly grasp how ISF can work with chronic pain. You see once the pain lasts longer than the time it takes to heal, it is chronic. During the chronicity process, the pain may become functionally connected to the self-representational Default Mode Network, one of the cardinal behavioral networks that makes up the Triple Network theory of psychopathology. The transformation of acute to chronic pain changes it from an experienced sensation to a characterological pillar of the self. That is to say, your sense of self becomes defined by the experience of chronic pain. This characterological pain transformation is what makes the condition so difficult to treat. But our research suggests a cause and a remedy. Chronic pain interferes with the smooth working of the three pain pathways. The inhibitory pain pathway in particular, becomes compromised.

Chronic pain can be separated into three interconnected pathways, a lateral “painfulness” pathway, a medial, “suffering” pathway, and a pain “inhibitory” pathway. In recent studies, fMRI determined a neural signature for acute pain with 94% accuracy. The neural signature comprised components of the lateral and medial pathways. In contrast, analysis of 92 studies on chronic pain does not show any activity in the descending pain inhibitory pathway. But the involvement of the lateral and medial pain pathway is still present. The comparisons clearly suggests that chronic pain may be the result of a deficiency in activation of the pain suppression pathway, rather than the increased activation of the ascending pain pathways.

If the inhibitory pain pathway becomes compromised, then very often chronic pain clients present with other symptoms such as depression, anxiety, sleep problems, as well as cognitive dysfunction, including problems of attention, learning difficulties, memory problems, and poor decision making. These profound comorbidities can make life a misery for clients who suffer with chronic pain.

In our research, available on the website, we addressed all three pain pathways. They all provided statistically significant relief to the experimentals compared to the sham controlled group. However, those subjects in the inhibitory pain pathway training group experienced statistically significant relief that occurred more quickly and lasted longer than the other experimental and control groups. Additionally, this group experienced greater functional improvement compared to the other groups.

So if you are in pain, whether it is knee, back, or other joint pain, please consider ISF sLORETA neurofeedback. We have extensive clinical experience working with general headache pain, migraine patients, and menstrual pain successfully. Our success is due to our research and clinical experience, we have the means at our disposal to normalize the pain inhibitory pathway, reducing pain and allowing for a better-regulated sense of self.

Adhia, D. B., Mani, R., Mathew, J., O’Leary, F., Smith, M., Vanneste, S., & De Ridder, D. (2023). Exploring electroencephalographic infraslow neurofeedback treatment for chronic low back pain: a double-blinded safety and feasibility randomized placebo-controlled trial. Scientific Reports, 13(1), 1177. doi:10.1038/s41598-023-28344-2

Adhia, D. B., Mani, R., Turner, P. R., Vanneste, S., & De Ridder, D. (2022). Infraslow Neurofeedback Training Alters Effective Connectivity in Individuals with Chronic Low Back Pain: A Secondary Analysis of a Pilot Randomized Placebo-Controlled Study. Brain Sciences, 12(11), 1514. Retrieved from https://www.mdpi.com/2076-3425/12/11/1514

De Ridder, D., Vanneste, S., Smith, M., & Adhia, D. (2022). Pain and the Triple Network Model. Frontiers in Neurology, 13. doi:10.3389/fneur.2022.757241

Mathew, J., Adhia, D. B., Smith, M. L., De Ridder, D., & Mani, R. (2022). Source localized infraslow neurofeedback training in people with chronic painful knee osteoarthritis: A randomized, double-blind, sham-controlled feasibility clinical trial. Frontiers in Neuroscience, 16. doi:10.3389/fnins.2022.899772