Back Pain Seen On The Brain

It's difficult for doctors and patients to talk about back pain since it is so subjective. A new imaging technique that shows the brain's activated areas during back pain may be a first step.

A new imaging technique called arterial spin labeling showed that blood flow to specific areas of the brain increased with chronic, worsening lower back pain. The brain activity occurred in the network of areas in the brain that process pain and mood.

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Dr. Ajay Wasan, lead author and a researcher in the Pain Management Center at Brigham Women's Hospital, said the study puts doctors closer to objectively describing chronic pain. Dr. Wasan said he was hopeful that the finding could lead to an understanding of an individual patient's neurocircuitry, which in turn could result in therapies tailored to each individual.

Investigators compared 16 chronic low back pain participants with 16 healthy individuals. Each participant underwent three imaging sessions. The first was for characterization and training, while in the second researchers used clinical maneuvers such as pelvic tilting or straight leg raising to make the pain worsen.

In the third session, heat was applied to the skin at an intensity that matched pain levels during the second session. Patients were asked to rate their pain before and after session, and after stimulation during sessions.

In addition, researchers used the arterial spin labeling technique during the last two sessions, which allowed them to quantify blood flow to particular regions of the brain. The amount of blood flow indicates neuron activity.

They discovered that there was increased brain activity from the chronic back pain group when they experienced worsening pain. However, that was not the case during the heat sessions or in the healthy group.

Some of the areas activated during worsening pain were previously linked to other types of pain in other research. But researchers did observe activation in some areas, such as the superior parietal lobule, that were not usually associated with pain in previous studies.

The research was published in journal Anesthesiology.