Predicting Chronic Back Pain

Woman with Chronic Back Pain

Doctors are using brain scans to better predict chronic pain in patients.


Researchers have found that back pain really might be in your head. A study conducted at Northwestern University’s Feinberg School of Medicine in Chicago suggests that an individual’s predisposition to develop chronic low back pain may be determined by the structure of their brain.

The team scanned the brains of 46 participants who reported having low back pain for approximately three months before coming to the hospital but no pain for at least a year before. The patients’ brains were scanned using a technique called diffusion tensor imaging (DTI), which is able to measure the structure of the white matter—comprised of nerve cell wires, or axons—which connect brain cells in different parts of the brain. They scanned the subjects’ brains four times over a period of twelve months.

Half of the participants recovered at some time during the year; the other half that had pain the entire time were categorized as persistent. Researchers found that the white matter brain scans predicted at least 80 percent of the ultimate outcomes. The results were published in the journal Pain.

Vania Apkarian, the study’s senior author and professor of physiology at the Fenton School believes the research may have identified an anatomical marker in the brain related to chronic pain. The finding is important because chronic pain affects nearly 100 million Americans, with an annual treatment price tag of up to $635 billion.

It is also a condition that is afflicting a growing number of individuals every year, putting a strain on our healthcare system. Its impact is so great that the United States government has outlined a plan to reduce that burden through a multi-pronged effort that includes enhanced research.

In the United States, chronic low back pain represents slightly more than a quarter of all causes of pain in the United States. The conventional wisdom was that the cause of low back pain would be found at the site of injury. But the recent research suggests the brain plays a bigger part than ever suspected. The research could prove significant to treatment models because the earlier the pain is detected the better the success of the treatments.

Apkarian’s team also showed that the volume of grey matter in the brains of those with persistent pain decreased over the same year. Grey matter describes the part of the brain composed of nerve cell bodies and their dendrites and some supportive tissue. The far reaching effects of chronic pain make it more imperative to visit your chiropractor at the first sign of discomfort.

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