A group of scientists have revealed results directly relating areas of the brain responsible for emotional responses, to patients that develop chronic back pain over time.

Relying on fMRI scans to determine the full extent of the connection, the scientists suggest that the detection of early brain changes may hold the key to identifying patients that are at a high risk of chronic back pain.

Once these changes have been categorised, drugs can be developed to manage the symptoms and possibly even cure back pain.

The Results

Shown for the first time in Nature Neuroscience, Professor Vania Apakarian has proved that the more communication there is between specific parts of the brain, the greater the chance of mild back pain becoming chronic.

When individuals have emotional responses to events, the insula region of the brain becomes active. Furthermore, the nucleus accumbens is responsible for teaching the brain to adapt to different surroundings, and also becomes active when stimulated by new environments.

The scientists’ research suggests that a person’s ability to recover is as much to do with the state of the brain, as well as the extent of the injury itself. In other words, the on-going pain from an injury is a result of the activity between different parts of the brain.

Previous Limitations

Previous research on chronic back pain has been hindered by limitations in study design. For example, comparisons have been made between healthy brains and brains dealing with back pain, however scientists have not been able to identify the reasons why the pain becomes chronic.

People with spinal injury claims continue to suffer chronic back pain years after an accident.
Other limitations the researchers discovered included not being able to analyse the different causes of back pain – changes in medication or home furniture for example. Previously, scientists were only able to take snap shots of pain-related brain activity at one point in time.

With these types of studies, research is limited to discovering links, leaving scientists to only suggest ways in which the pain is driven by the brain. However with this latest discovery, scientists expanded their research to longitudinal methods, taking multiple measures over a period of time.

The Study

The study consisted of 39 people with sub-acute to moderate back pain. For the study to be valid, it was necessary that each patient had no history of back pain, and their current paid started 1-4 months previously.

Patients were subjected to an initial assessment, and then three more over the course of the year including fMRI scans. They were also asked to rate the levels of their pain over the course of the assessments.

The research revealed that there was a much greater level of communication between the insula and nucleus accumbens parts of the brain in patients whose back pain became chronic. Furthermore, analysing their data, it was agreed that the early scans had an 85 per cent of predicting which participants would continue to have chronic back pain.

Hailed as a breakthrough in the treatment of back pain, future generations will benefit from this in-depth research. As more drugs are developed, and different ways of recovery are introduced into medicine, thousands of people will profit and be able to take advantage from this detailed discovery.