Does Lower Back Pain Affect The Brain?




Does Lower Back Pain Affect The Brain?


brainOkay, so it’s not the first thought that pops into your head when you are suffering with back pain. But it poses an interesting question, and it also gives some amazing insights into the long term affects of putting up with a chronic niggle in the back.

Most of us (80{95f364b8aea3ba4afb976a81c1dcc2e8147daac1866ef443968911255633a999} of the adult population) have had back pain at some point in our lives. However we never stop to think about what is actually happening inside our bodies when we experience pain. Usually we just want to make it stop, and fast! Totally understandable, pain is annoying at the very least. And fortunately most instances of pain will sort themselves out within minutes to a few days. It is not until the pain doesn’t go away that we consider there might be a problem, and we start to wonder what is actually going on.

Unlike basic ‘touch’, the sensation of pain is not well understood. It is a very personal experience, and there is no way to measure it aside from asking someone how much it hurts on a scale of 1 to 10. Often there is a lot of emotion and memory that is tied up in feeling pain as well, making it even more difficult to understand.

What we do know is that there are nerve endings (called nociceptors) all through our bodies. These nerve endings register an injury or tissue damage, and send a signal to the brain. This signal is interpreted as pain. Different types of nerve endings send different signals to the brain, for example light touch is transmitted along different nerves than hot, which is different to cold etc.

So when we hurt ourselves, say you stub your toe, the pain nerves (nociceptors) from your toes will send a signal up your leg, into your spinal cord, and all the way up to your brain. This is where your brain registers and ‘feels’ the pain and makes you go ‘OUCH’! Acute pain is an alarm from the body saying ‘You are hurt, attend to it!’. 

What is interesting is that pain nerves are relatively slow at carrying that signal. That is why there is often a slight time lag before an injury will start to hurt. So often you will say “Ohh, I just stubbed my toe…(pause)….OUCH’. It is not until the brain receives and processes the pain signal from your body that you will consciously ‘feel’ the pain. 


Modern brain scans (Positron Emission Tomography, or PET scans) allow us to see these signals reaching and activating/stimulating the brain. Specific areas of the brain ‘light up’ when they are active, and this is easily visible on some scans. So when we are experiencing pain, a certain spot in the brain that relates exactly to the part of the body that is hurt will light as active on the brain scan. Areas of the brain that process thought, sensation, movement, emotion and memory are also seen to be active when we are experiencing pain, particularly chronic pain. This observation explains why when we are in pain we often have trouble concentrating or thinking well, moving becomes difficult, more sensitive to loud noises or bright light, and we can become emotional, angry or irritable. The sensation of pain can become completely overwhelming, taking over your entire experience of the world at that point in time.

What is really interesting is that when we suffer from chronic pain (lasting 3 months or longer) more of the brain becomes active in the pain response. This is seen on PET scans as more of the brain area lighting up. If the pain receptors fire repeatedly, they can start to cause a change in the brain where the nerves continue to fire after the original cause of the pain is gone. The brain is starting to form a more permanent impression, or memory, of the pain. 

You can think of this as being like trying to memorise a new phone number. At first it is impossible for most of us to remember a random string of numbers, but with repetition and time, you can easily remember the phone number instantly. It becomes locked into your memory, just as chronic pain can. This ‘locked in’ memory of your pain in turn leads to becoming more sensitised to pain. It will take less of an injury to cause pain, as the brain is already primed ready to react to the slightest irritant.

A recent study also demonstrated that suffering chronic pain may actually cause your brain to shrink. The researchers found that people who suffered with back pain for a year or longer had up to 11{95f364b8aea3ba4afb976a81c1dcc2e8147daac1866ef443968911255633a999} less grey matter in their brains. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal ageing. The decreased volume was related to pain duration, indicating a 1.3 cm cubed loss of gray matter for every year of chronic pain. The long term implications of this are unknown, but it certainly is a strong indication of how dramatic the effects of tolerating chronic pain can be on your brain!

2581438627_c877326c43_bBut it is not all a one way, downhill street. Recent advances in neuroscience, in particular the field of neuroplasticity, are showing that you can actually reverse the long term memory of pain and the changes it causes to your brain. Basically, instead of focusing on the pain, think of something else when you are in discomfort. It may be a nice memory of a holiday, or time with friends and family. Our brains are very good at locking in stuff that we use every day, like how to navigate our way to work, or remembering a password. It also forgets the things we don’t use every day, such as all that geometry you learnt at school and never use.

One study showed that when people concentrated on a comforting thought such as a warm blanket on a cold day, they experienced much less pain. By not focusing on the pain, you are not allowing your brain to develop a permanent memory of it. For example, using the phone number analogy from before. If you didn’t repeat the new phone number to yourself over and over, it would be forgotten very quickly. Your brain has not had the time and repetition to form a permanent memory of the number. Even longer term memories slowly fade over time if we don’t think about them.

Lower back pain can be an insidious, life altering condition for many. Any pain we experience has a direct and immediate effect on the brain, and this can lead to long term, permanent (although mostly reversible) changes over time. Visualisation techniques are proving to be very effective at changing our response to chronic pain, but they do require time, commitment and effort to work.

If you have any questions, or would like to share your own experience, please leave us a comment below.

Also, if you have found this article helpful, please share it so we can help even more people! Thankyou.








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