New Insight Reveals the Back Pain in Your Brain

New Insight Reveals the Back Pain in Your Brain Blog

If someone tells you your chronic back pain is all in your brain, you may be insulted or become downright angry. Anyone suffering chronic back pain knows how nagging and miserable it can be. Yet in many cases, chronic back pain is not caused by structural anomalies, but by the central nervous system (CNS) itself.

Many people suffer ongoing back pain for years, trying various treatment methods with little or no success. Even surgical interventions do not always resolve back pain, and in some cases surgery may lead to further degeneration of your spine. New research on the brain activities of chronic pain patients sheds some light on the source of chronic back pain in some people.

Central Sensitization and Chronic Pain

Central sensitization (CS) is a CNS condition that has to do with the development and maintenance of ongoing pain. It entails a process called wind-up where the CNS is regulated into a highly reactive state which lowers the pain threshold and maintains a certain level of pain, even after the initial injury or cause of pain has healed.

CS has two primary characteristics that heighten sensitivity to pain and intensify the sense of touch:

  • Allodynia: With this characteristic, patients experience pain from things that are not ordinarily painful, such as light massage or even simple touch. The nerves in the area are so sensitized that they send signals to the brain that produce a strong feeling of pain or discomfort.
  • Hyperalgesia: This characteristic occurs when a normally painful stimulus is perceived as much more painful that it ought to be. For example, a simple bump that most people would treat as an annoyance may send a patient with hyperalgesia through the roof with excruciating pain.

In either case, the persistent state of the CNS is highly reactive, amplifying pain in some people. Chronic back pain is one area where CS is often prevalent.

Causes of Central Sensitization

Central sensitization is the result of changes to the CNS, particularly in the dorsal horn of the spinal cord and in the brain. These changes occur at the cellular level, often at receptor sites.

Spinal cord injuries and strokes have been known to trigger central sensitization because they directly affect the CNS. However, many patients develop CS as a result of a peripheral injury that does not directly impact the CNS. Scientists have identified certain factors that may contribute to the neural changes leading to CS.

  • Predisposition: Certain biological, psychological and environmental characteristics are suspected to be culprits in patients prone to CS. Genetic factors may play a role, as may an amplified stress-response that can lower a patient’s pain threshold. Patients with a history of anxiety, physical or psychological trauma or depression are more prone to experience CS later in life.
  • Post-onset CS: After the original onset of pain, other factors can come into play that instigate a CS response. Anxiety, depression and fear-avoidance after an injury can heighten CNS reactivity and lead to CS. Disrupted sleep patterns as a result of chronic pain can exacerbate CS.

Treatment for Central Sensitization

Treatments for CS target the CNS and corresponding inflammation. Treatment may include:

  • Physical therapy
  • Cognitive therapy
  • Mild aerobic exercise
  • Medications, including NSAIDs and antidepressants

Treatment programs typical incorporate a multimodal approach. The prevailing theory is that if pain can be felt, then it can be treated.

Treatment for CS in NYC

If you are tired of living with chronic back pain and have tried everything to find a solution, you may be experiencing CS. The pain specialists at NYDNRehab stay on the cutting edge of research and treatments for chronic pain, and have the expertise and resources to resolve CS. Do not let the pain in your brain keep you from getting well. Contact NYDNRehab today, and see why our team of pain specialists is the very best in NYC.

 

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