Changes in the Brain Predict Chronic Low Back Pain a Year Later

This is one of those research articles I refer to often. It’s titled: ‘Predicting transition to chronic pain’. What is so interesting about this research is they did brain scans at the time of an acute low back pain episode and then again a year later. In the people whose pain became chronic, they found pre-existing brain changes are what predicted the pain becoming chronic- and they found this in greater than 80% of the people whose pain continued after a year. Essentially when the brain is in a stressed state, there is a risk of acute pain becoming chronic pain. 

The takeaway here is that it was the brain that predicted acute back pain becoming chronic, not the back.

‘At the time of entry into the study, strength of synchrony between the medial prefrontal cortex and nucleus accumbens (i.e. functional connectivity) was predictive (>80% accuracy) of individuals who subsequently transition to chronicity 1 year later.’

‘Properties of the brain’s emotional learning circuitry predict the transition to chronic pain. The involvement of this circuitry in pain remains mostly unexplored. Future human and animal model studies are necessary to unravel underlying mechanisms driving pain chronicity, with the potential of advancing novel therapeutics for preventing pain chronification.’

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887742/