New findings from the Northwestern University Feinberg School of Medicine in Chicago, Illinois may change the way physicians treat patients’ pain. According to new Northwestern Medicine® research, after a lower back injury, abnormalities in the structure of the brain dispose people to develop chronic pain. It has long been assumed by clinicians and scientists that chronic back pain stems from the site of the original injury.
The research was published in the journal Pain and funded by the National Institutes of Health. Professor of physiology at Northwestern University Feinberg School of Medicine and senior author of the study, A. Vania Apkarian said, “We’ve found the pain is triggered by these irregularities in the brain. We’ve shown abnormalities in brain structure connections may be enough to push someone to develop chronic pain once they have an injury.”
The findings were based on people who had a new lower back injury and their MRI brain scans. The scientists scanned the brains of 46 people who had an episode of lower back pain for at least four weeks and no pain for at least one year before that. The pain had to be rated at least five out of 10 on a pain scale to be included in the study. At the onset of the injury and after one year, those patients with the persistent pain had the same structural abnormalities in their white matter.
With about 85 percent accuracy, the scientists were able to predict which patients would have persistent back pain. A specific marker or irregularity identified in the axons was the predictor. Axons are pathways in the brain’s white matter, which connect brain cells so they can communicate. This provides a different view of treating chronic pain. Chronic back pain costs up to $635 billion a year to treat and affects nearly 100 million Americans.
“We think the people who are vulnerable need to be treated aggressively with medication early on to prevent their pain from becoming chronic,” says Apkarian. “Last year, we showed people who take medication early on had a better chance of recovering. Medication does help.”
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