10 ms·

Chronic lower back pain linked to atrophy in pain-related brain regions

111 points by rajnathani 5y ago

kuboble 5y ago
I'm suffering from severe chronical lower back pain. > Yet approximately 90% of patients with CLBP cannot identify any clear specific cause or origin of their pain. Same here. More than once in my life I seemed to not feel any pain unless my injury get to the point of damage preventing proper physical operations. It feels like I was doing something wrong and didn't get feedback from my body until it was too late. Learning from this article about correlation between lower back pain and with lower brain volumes in pain-related brain areas strikes home.
- CipherThrowaway 5y ago
  If you found the article interesting you might want to look into Explaining Pain (EP). Teaching patients about pain is a common approach in treatment and there is some clinical evidence that better understanding can make pain easier to manage or even reduce the experience of pain (e.g. https://pubmed.ncbi.nlm.nih.gov/14690673/ https://pubmed.ncbi.nlm.nih.gov/14690673/).
- agumonkey 5y ago
  I think society should have preventive instructions because indeed there are subtle shifts we can't yet notice until too late. Regular full body exercise may improve things (improve proper mechanical use, diffusion of efforts, preserving sensitive articulations like discs).
  - flatiron 5y ago
    I think regular full body exercise has been preached to me my entire life.
    - matwood 5y ago
      Because it works. A strong core and regular movement does wonders for preventing a lot of back pain. Obviously an overuse (someone lifting all day) or acute injury is different, but for the common office worker, exercise gets amazing results.
      - pawelwentpawel 5y ago
        I agree with this. One of the best things I've done last year was signing up to a powerlifting gym and working through all the basic movements (from a long warmup to compound movements) with a professional trainer. It did wonders for my lower back.
        rajin444 5y ago
        Likewise. I used to have chronic back pain sitting. Consistent deadlifting seems to have fixed that.
        schnebbau 5y ago
        Ah deadlifting. Undeniably one of the best movements there is... Until you irreversibly damage your spine.
        pawelwentpawel 5y ago
        Spine problems from weights are no joke here for sure - been there, done that. That's why I emphasised on the professional trainer in the original post. Technique and staying within your limits are really important to avoid any injuries.
        agumonkey 5y ago
        Any good resources (videos, books) about this ? I'm in ~rehab so I'm used to take it slow, and be very careful about the mechanics and cardiac limits, but I sure want to know more.
- nchi3 5y ago
  You might have heard about this or tried it, but if not: There's some very promising studies from last year regarding treatment of CLBP that doesn't seem to have a physiological cause[1]. This type of "treatment" helped me turn around my backpain (both upper and lower) which had been getting worse and worse over ~6 months (not very long, I know), and after a few months I was virtually pain free. This type of therapy is not new, but it's only very recently that proper big and reputable studies have been done. Most people don't even need to see a professional, reading online and doing it on your own is enough for the majority (including me). [1]: https://www.colorado.edu/today/2021/09/29/how-therapy-not-pills-can-nix-chronic-pain-and-change-brain https://www.colorado.edu/today/2021/09/29/how-therapy-not-pi...
  - elliekelly 5y ago
    Have there been any studies comparing the brains of people who derive pleasure from pain vs people who don’t? I wonder if this could be related? Some people seem to have “trained” their brains not to recognize pain signals as unpleasant. Or (because I imagine they still feel pain) maybe they can even decide when and which pain signals are pleasant vs unpleasant? I wonder if people who enjoy BDSM are any more or less likely to suffer from chronic pain than the rest of the population.
  - denvaar 5y ago
    This is an interesting article. I would like to hear more information about how the therapy is actually done. This reminds me of techniques like Edmund Jacobson's "Progressive Relaxation". I'm also reading a book called, "A Headache in the Pelvis", which claims that essential to healing is this idea that we must learn to properly relax and accept the pain we feel. I've found it hard to collect actual instruction about how to do this though.
    - mtalantikite 5y ago
      Yeah I'm very curious to know how this Pain Reprocessing Therapy (PRT) from the article is done. I haven't read the book you mentioned, but I'd say from my personal experience a physical yoga practice helps teach you to properly relax into what can sometimes be extreme discomfort. I remember when I first started practicing, whenever we'd get to long holds of poses (e.g. splits, pigeon, ustrasana), my body would start panicking and want me to come out of it immediately. But if you just keep bringing your awareness to the breath and meditate through the sensations that arise, the body starts relaxing and accepts where it's at. I can imagine the PRT therapy probably includes some subset of the four foundations of mindfulness [1]. [1] https://en.wikipedia.org/wiki/Satipatthana https://en.wikipedia.org/wiki/Satipatthana
- hesdeadjim 5y ago
  Someone mentioned it below, but the books by Dr. Sarno might help. My buddy had chronic back pain and was able to clear it out completely with his methods.
  - adrice727 5y ago
    About 10 years ago, I started having really bad low back pain and could barely get out of bed some mornings. Different doctors told me different things. I tried chiropractic, acupuncture, stretching - nothing was helping. Then I came across one of Sarno's books. I was very skeptical, but I found that within 20 pages, he had described my situation to a tee. I followed the advice in the book and was back to running and yoga within a week, and was lifting weights again a couple weeks later. Sarno's books and theories are a bit outdated at this point, but we now have people like Howard Schubiner and Nicole Sachs, and things like Curable. [1] https://pubmed.ncbi.nlm.nih.gov/34586357/ https://pubmed.ncbi.nlm.nih.gov/34586357/ [2] https://podcasts.apple.com/us/podcast/the-cure-for-chronic-pain-with-nicole-sachs-lcsw/id1439580309 https://podcasts.apple.com/us/podcast/the-cure-for-chronic-p... [3] https://www.curablehealth.com https://www.curablehealth.com
    - nchi3 5y ago
      Also very related to the study I linked in another response, though under the guise of pain reprocessing therapy (PRT). An interesting read if you want to know more about the latest scientifical progress on this type of therapy!
superlopuh 5y ago
There are certain mind-altering substances that make my back hurt, I wonder if they're unsuppressing the pain that I would be feeling all the time if not for this mechanism.
- superlopuh 5y ago
  That seems like a freebie for a study, feed patients psychedelics and see if that region of the brain activates.
- kostyal 5y ago
  My back pain is significantly better now, but it comes back any time I take psychedelics. Have often wondered the same.
- waterfish 5y ago
  Anecdotally, cannabis seems to do that for me. Pain/soreness that I normally dont feel from a few previous injury becomes magnified and noticeable.
  - cmrdporcupine 5y ago
    Same here.
    - nitrogen 5y ago
      All my friends thought I was crazy when I pointed this out the first time I tried it.
      - cmrdporcupine 5y ago
        I hear all the time about how cannabis helps with pain management. Opposite with me.
  - y-c-o-m-b 5y ago
    I thought me and my cousin were the only ones with this issue. Cannabis makes my bones ache like nothing else and it feels like my tendons are being torn apart. I don't understand why. I used to smoke heavily between 2010-2013 without issue. I stopped and didn't try it again until 2017 or so, but it's never been the same since. It doesn't take much either. Just one mild hit and it's pain city.
throwawaybackp 5y ago
After reading "Back Mechanic," I've had a profound shift in my understanding of -- what used to be -- my own back pain: the usual cause is muscle imbalance. Something to the tune of: our back and torso muscles are responsible for keeping our spines (and all their structures) aligned in a healthy, mechanically-sound position. Things start to go wrong when the muscles are weak/atrophied/unbalanced, and no longer "hold" the vertebrae in their proper positions, which can lead to the disks bulging out and other mechanical issues that lead to low-intensity damage. With this in mind, I started stretching my back, and focusing on getting into a "neutral," or healthy, posture on a day-to-day (to remove the muscle tightness caused by me unconsciously hunching, and exacerbating the problem -- after having a herniated disc). In theory, this remedies the muscles pulling my vertebrae in the "wrong" directions and intensities. Coupled with weight training (squats, deadlifts, OHP, and bench), I believe I've managed to strengthen my back muscles, and "realigned" their efforts into the way my spine should be held up (instead of the way it was held up, due to sitting around all day). It's gotten much better, and I don't have pain or unintended tightness anymore. N.B. I've also relieved myself of knee pain, by focusing on the way my hips are "held" during walking. It seemed like mine were tilting too much forward (and not holding my body in place properly), so knee pain manifested (and perhaps was even the catalyst for my herniated disc). Once I straightened them out, I was able to walk pain-free.
- sjg007 5y ago
  The bird-dog pose, yoga and just improving core strength has helped me.
- sethammons 5y ago
  I'm in a similar boat. I was mountain biking 3x+ a week (6+ mi. climb at avg 6% grade) - I was getting fitter and losing weight. But my back would hurt on the down hill. Every jostle was teeth gritting. I started weight training and stretching and my regular back pain is a thing of the past. My backs squat went from around body weight to 2x body weight. When ever a pain shows up anywhere for me (knee, shoulder, wrist, back, etc), it is because of a muscle pulling on it out of balance. I stretch the muscle, the opposing muscle, and related muscles. Generally if my back is sore these days it is because I need to stretch my hips. A few minutes of stretching and I'm good to go.
ditegashi 5y ago
Read about Dr. Sarno
alecst 5y ago
The submitted article is poached from https://www.newswise.com/articles/chronic-low-back-pain-linked-to-atrophy-in-pain-related-brain-regions https://www.newswise.com/articles/chronic-low-back-pain-link.... (This page also links to the study in question.) The current link is sketchy, full of ads, and doesn’t link to the source article in Pain.
Aqwis 5y ago
That chronic pain can have a central, neuropsychiatric origin is likely to have been considered at least briefly by anyone who's learned that (or who has been prescribed them) antidepressants, of all things, are frequently prescribed for chronic pain that appears without a clear cause. I'm sure that the medicine of neurodegenerative diseases will receive more attention than almost any other field of medicine in the coming decades. Alzheimers, ALS and similar grave diseases are already major research priorities, but if chronic lower back pain and other chronic pain is definitely shown to frequently be the result of brain atrophy then better understanding (and hopefully treatments) may matter for a large part of the working population as well.
jakeinspace 5y ago
As someone with chronic back pain stemming from a clear event (car accident), I still have the feeling that a substantial amount of my pain is reflecting a change in my brain. It almost feels like my brain’s processing of pain was recalibrated, so that I now notice other forms of pain which might’ve flown under the radar previously. And that baseline of pain, in my back and elsewhere, certainly tracks with my overall level of depression/anxiety.
- tunap 5y ago
  I crushed my ribcage & sternum 20+ years ago & still live with pain in my shoulders and the vertebrae below my neck. When my day is running well(enough), the pain is present but barely registers in my consciousness. When non-physical tasks are a chore &/or I am depressed, they burn hotter than the sun. Physical activities seem to be the only remedy to abate it. I've found nothing beyond exercise relieves the pain when it's lit up: anti-inflams / pain killers don't do anything, chiropractors didn't help and imaging indicated no trauma to my spine. Perhaps it's some sort of arthritis or psychosomatic reminder, IDK, it's just another item on my 'getting old sucks' list.
  - hesdeadjim 5y ago
    I’ve had far too many injuries in my life due to enjoyment of adrenaline sports, and like you exercise is the only thing that seems to clear out the pain. Funny enough, letting my six year old beat the crap out of me while wrestling with her has been some of the best PT I’ve had.
- foamswimsuit 5y ago
  That describes exactly the neurological theories and approach of the physical therapy office I go to. The idea is that after traumatic events, the brain can recalibrate its pain registration threshold. Through the process of pushing to the edge of that boundary (and just barely beyond), over time it teaches your brain to reset back to a normal level. I have been to many physical therapists and this was very unique and compelling for me, and several months in I am on a good path.
- 5y ago
mkl95 5y ago
I have chronic back pain. So far, several doctors agree that the symptoms are there, but none of them have been able to identify the cause. Pain and the mobility issues that come with it sometimes disappear briefly, for an hour or so. I know it sounds crazy, but sometimes I can make the pain go away by focusing on it. None of it seems to make sense.
- gameswithgo 5y ago
- andai 5y ago
  Maybe it's like a messaging system. When you read the message, the notification goes away.
  - babyshake 5y ago
    Pain usually doesn't work this way. It's relatively stateless, as in as long as there is a problem in a part of your body you'll feel pain associated with it, and it's not like the pain goes away once you ack it.
- wise0wl 5y ago
  This is not surprising. Pretty much anything that we experience subjectively can be affected by willful projection of our mental intention. Placebo effect is another name for this phenomenon. Meditative states and specific focus in those meditative states can cause cessation of pain, states of euphoria, tingling, out-of-body sensations, etc.
  - garciasn 5y ago
    I have intermittent (usually bi-annually) severe back pain stemming from what has been determined by MRI as a congenital/hereditary narrowing of the spine that causes muscle spasms and long-lasting pain. I'm currently in one of my bi-annual cycles and this one is particularly nasty. 800mg ibuprofen + 1500mg of acetaminophen + 10mg cyclobenzaprine every four hours was doing absolutely nothing for the symptoms. I ended up trying every other remedy under the sun including epsom salt baths, Tiger Balm, etc., for relief. What worked? CBD balm. I don't believe in anything that can be attributed to the placebo effect and that's what I consider remedies like CBD balm. But, it worked and I am going to run w/it. I wish it were easier than me having to fork over $30 for snake oil to trick my body into a positive response but here we are.
lkrubner 5y ago
Based on personal experience, my sense is that much back pain is caused by bacteria. Obviously some people have a specific injury that causes their back pain, but I think doctors have an easier time finding the problem, when there was a specific injury. But when the pain slowly appears with aging, and has no specific cause, I suspect bacteria plays a role. As an analogy, most cases of pneumonia are caused by streptococcus pneumococcus, and most of us have this bacteria in our lungs by the time we are 5 years old, and yet the bacteria lives in our lungs for most of our lives, and it does no damage, so long as our immune system is healthy. But then one day, when we are 85 years old, the streptococcus pneumococcus becomes active and hurts us. This is after 80 years of peaceful coexistence. At one point I was looking up incidence of disease on the CDC website, and I was surprised to see that they said 1 out of 3 Americans test positive for exposure to neisseria meningitis, which can cause spinal meningitis. Only about 55 Americans a year die from this, so this is a bacteria which apparently reaches 100 million Americans but causes death in less than 0.000000001% cases. But maybe it can cause back pain? Maybe as we get older, and our immune system is less active, neisseria meningitis could cause inflammation in the spine? I once had an illness that doctors thought was Lyme disease. Among other things, it gave me agonizing back pain, so bad that I would have to lie on the couch all day, unable to move. But antibiotics fully resolved the situation. So the fact that bacteria can cause back pain is well known to me, and the fact that antibiotics can solve back pain, in some cases, is also well known to me.
- lkrubner 5y ago
  I’m curious why this was downvotes?
- meristohm 5y ago
  I had a deer-tick bite a while back, though the two tests for tick-borne illness came back negative. Coincidentally my back pain (which I'd had already) became more acute. I don't know if it was causative, and it seems more likely that it was stress and other factors, but I keep this story around just in case.
not2b 5y ago
Assuming that this is a real effect, it seems that the causality could be in either direction: perhaps atrophy in the brain contributes to pain, or perhaps constant pain causes the pain-related regions of the brain to atrophy.
glouwbug 5y ago
Start deadlifting in your 20s and 30s and you'll do just fine
- joeman1000 5y ago
  Any resources on this? I’m interested. I’ve tried stretching, cycling, hot baths & a stand-up desk. I messed mine up diving off a boat 8 years ago.
  - glouwbug 5y ago
    Strong Lifts. The app is free. 3x a week
- reducesuffering 5y ago
  Personally, it's squats that make any back pain starting go away like clockwork.

111 points by rajnathani 5y ago

I'm suffering from severe chronical lower back pain. > Yet approximately 90% of patients with CLBP cannot identify any clear specific cause or origin of their pain. Same here. More than once in my life I seemed to not feel any pain unless my injury get to the point of damage preventing proper physical operations. It feels like I was doing something wrong and didn't get feedback from my body until it was too late. Learning from this article about correlation between lower back pain and with lower brain volumes in pain-related brain areas strikes home.

CipherThrowaway 5y ago
If you found the article interesting you might want to look into Explaining Pain (EP). Teaching patients about pain is a common approach in treatment and there is some clinical evidence that better understanding can make pain easier to manage or even reduce the experience of pain (e.g. https://pubmed.ncbi.nlm.nih.gov/14690673/ https://pubmed.ncbi.nlm.nih.gov/14690673/).
agumonkey 5y ago
I think society should have preventive instructions because indeed there are subtle shifts we can't yet notice until too late. Regular full body exercise may improve things (improve proper mechanical use, diffusion of efforts, preserving sensitive articulations like discs).
- flatiron 5y ago
  I think regular full body exercise has been preached to me my entire life.
  - matwood 5y ago
    Because it works. A strong core and regular movement does wonders for preventing a lot of back pain. Obviously an overuse (someone lifting all day) or acute injury is different, but for the common office worker, exercise gets amazing results.
    - pawelwentpawel 5y ago
      I agree with this. One of the best things I've done last year was signing up to a powerlifting gym and working through all the basic movements (from a long warmup to compound movements) with a professional trainer. It did wonders for my lower back.
      - rajin444 5y ago
        Likewise. I used to have chronic back pain sitting. Consistent deadlifting seems to have fixed that.
        schnebbau 5y ago
        Ah deadlifting. Undeniably one of the best movements there is... Until you irreversibly damage your spine.
        pawelwentpawel 5y ago
        Spine problems from weights are no joke here for sure - been there, done that. That's why I emphasised on the professional trainer in the original post. Technique and staying within your limits are really important to avoid any injuries.
        agumonkey 5y ago
        Any good resources (videos, books) about this ? I'm in ~rehab so I'm used to take it slow, and be very careful about the mechanics and cardiac limits, but I sure want to know more.
nchi3 5y ago
You might have heard about this or tried it, but if not: There's some very promising studies from last year regarding treatment of CLBP that doesn't seem to have a physiological cause[1]. This type of "treatment" helped me turn around my backpain (both upper and lower) which had been getting worse and worse over ~6 months (not very long, I know), and after a few months I was virtually pain free. This type of therapy is not new, but it's only very recently that proper big and reputable studies have been done. Most people don't even need to see a professional, reading online and doing it on your own is enough for the majority (including me). [1]: https://www.colorado.edu/today/2021/09/29/how-therapy-not-pills-can-nix-chronic-pain-and-change-brain https://www.colorado.edu/today/2021/09/29/how-therapy-not-pi...
- elliekelly 5y ago
  Have there been any studies comparing the brains of people who derive pleasure from pain vs people who don’t? I wonder if this could be related? Some people seem to have “trained” their brains not to recognize pain signals as unpleasant. Or (because I imagine they still feel pain) maybe they can even decide when and which pain signals are pleasant vs unpleasant? I wonder if people who enjoy BDSM are any more or less likely to suffer from chronic pain than the rest of the population.
- denvaar 5y ago
  This is an interesting article. I would like to hear more information about how the therapy is actually done. This reminds me of techniques like Edmund Jacobson's "Progressive Relaxation". I'm also reading a book called, "A Headache in the Pelvis", which claims that essential to healing is this idea that we must learn to properly relax and accept the pain we feel. I've found it hard to collect actual instruction about how to do this though.
  - mtalantikite 5y ago
    Yeah I'm very curious to know how this Pain Reprocessing Therapy (PRT) from the article is done. I haven't read the book you mentioned, but I'd say from my personal experience a physical yoga practice helps teach you to properly relax into what can sometimes be extreme discomfort. I remember when I first started practicing, whenever we'd get to long holds of poses (e.g. splits, pigeon, ustrasana), my body would start panicking and want me to come out of it immediately. But if you just keep bringing your awareness to the breath and meditate through the sensations that arise, the body starts relaxing and accepts where it's at. I can imagine the PRT therapy probably includes some subset of the four foundations of mindfulness [1]. [1] https://en.wikipedia.org/wiki/Satipatthana https://en.wikipedia.org/wiki/Satipatthana
hesdeadjim 5y ago
Someone mentioned it below, but the books by Dr. Sarno might help. My buddy had chronic back pain and was able to clear it out completely with his methods.
- adrice727 5y ago
  About 10 years ago, I started having really bad low back pain and could barely get out of bed some mornings. Different doctors told me different things. I tried chiropractic, acupuncture, stretching - nothing was helping. Then I came across one of Sarno's books. I was very skeptical, but I found that within 20 pages, he had described my situation to a tee. I followed the advice in the book and was back to running and yoga within a week, and was lifting weights again a couple weeks later. Sarno's books and theories are a bit outdated at this point, but we now have people like Howard Schubiner and Nicole Sachs, and things like Curable. [1] https://pubmed.ncbi.nlm.nih.gov/34586357/ https://pubmed.ncbi.nlm.nih.gov/34586357/ [2] https://podcasts.apple.com/us/podcast/the-cure-for-chronic-pain-with-nicole-sachs-lcsw/id1439580309 https://podcasts.apple.com/us/podcast/the-cure-for-chronic-p... [3] https://www.curablehealth.com https://www.curablehealth.com
  - nchi3 5y ago
    Also very related to the study I linked in another response, though under the guise of pain reprocessing therapy (PRT). An interesting read if you want to know more about the latest scientifical progress on this type of therapy!

superlopuh 5y ago

There are certain mind-altering substances that make my back hurt, I wonder if they're unsuppressing the pain that I would be feeling all the time if not for this mechanism.

superlopuh 5y ago
That seems like a freebie for a study, feed patients psychedelics and see if that region of the brain activates.
kostyal 5y ago
My back pain is significantly better now, but it comes back any time I take psychedelics. Have often wondered the same.
waterfish 5y ago
Anecdotally, cannabis seems to do that for me. Pain/soreness that I normally dont feel from a few previous injury becomes magnified and noticeable.
- cmrdporcupine 5y ago
  Same here.
  - nitrogen 5y ago
    All my friends thought I was crazy when I pointed this out the first time I tried it.
    - cmrdporcupine 5y ago
      I hear all the time about how cannabis helps with pain management. Opposite with me.
- y-c-o-m-b 5y ago
  I thought me and my cousin were the only ones with this issue. Cannabis makes my bones ache like nothing else and it feels like my tendons are being torn apart. I don't understand why. I used to smoke heavily between 2010-2013 without issue. I stopped and didn't try it again until 2017 or so, but it's never been the same since. It doesn't take much either. Just one mild hit and it's pain city.

throwawaybackp 5y ago

After reading "Back Mechanic," I've had a profound shift in my understanding of -- what used to be -- my own back pain: the usual cause is muscle imbalance. Something to the tune of: our back and torso muscles are responsible for keeping our spines (and all their structures) aligned in a healthy, mechanically-sound position. Things start to go wrong when the muscles are weak/atrophied/unbalanced, and no longer "hold" the vertebrae in their proper positions, which can lead to the disks bulging out and other mechanical issues that lead to low-intensity damage. With this in mind, I started stretching my back, and focusing on getting into a "neutral," or healthy, posture on a day-to-day (to remove the muscle tightness caused by me unconsciously hunching, and exacerbating the problem -- after having a herniated disc). In theory, this remedies the muscles pulling my vertebrae in the "wrong" directions and intensities. Coupled with weight training (squats, deadlifts, OHP, and bench), I believe I've managed to strengthen my back muscles, and "realigned" their efforts into the way my spine should be held up (instead of the way it was held up, due to sitting around all day). It's gotten much better, and I don't have pain or unintended tightness anymore. N.B. I've also relieved myself of knee pain, by focusing on the way my hips are "held" during walking. It seemed like mine were tilting too much forward (and not holding my body in place properly), so knee pain manifested (and perhaps was even the catalyst for my herniated disc). Once I straightened them out, I was able to walk pain-free.

sjg007 5y ago
The bird-dog pose, yoga and just improving core strength has helped me.
sethammons 5y ago
I'm in a similar boat. I was mountain biking 3x+ a week (6+ mi. climb at avg 6% grade) - I was getting fitter and losing weight. But my back would hurt on the down hill. Every jostle was teeth gritting. I started weight training and stretching and my regular back pain is a thing of the past. My backs squat went from around body weight to 2x body weight. When ever a pain shows up anywhere for me (knee, shoulder, wrist, back, etc), it is because of a muscle pulling on it out of balance. I stretch the muscle, the opposing muscle, and related muscles. Generally if my back is sore these days it is because I need to stretch my hips. A few minutes of stretching and I'm good to go.

ditegashi 5y ago

Read about Dr. Sarno

alecst 5y ago

The submitted article is poached from https://www.newswise.com/articles/chronic-low-back-pain-linked-to-atrophy-in-pain-related-brain-regions https://www.newswise.com/articles/chronic-low-back-pain-link.... (This page also links to the study in question.) The current link is sketchy, full of ads, and doesn’t link to the source article in Pain.

Aqwis 5y ago

That chronic pain can have a central, neuropsychiatric origin is likely to have been considered at least briefly by anyone who's learned that (or who has been prescribed them) antidepressants, of all things, are frequently prescribed for chronic pain that appears without a clear cause. I'm sure that the medicine of neurodegenerative diseases will receive more attention than almost any other field of medicine in the coming decades. Alzheimers, ALS and similar grave diseases are already major research priorities, but if chronic lower back pain and other chronic pain is definitely shown to frequently be the result of brain atrophy then better understanding (and hopefully treatments) may matter for a large part of the working population as well.

jakeinspace 5y ago

As someone with chronic back pain stemming from a clear event (car accident), I still have the feeling that a substantial amount of my pain is reflecting a change in my brain. It almost feels like my brain’s processing of pain was recalibrated, so that I now notice other forms of pain which might’ve flown under the radar previously. And that baseline of pain, in my back and elsewhere, certainly tracks with my overall level of depression/anxiety.

tunap 5y ago
I crushed my ribcage & sternum 20+ years ago & still live with pain in my shoulders and the vertebrae below my neck. When my day is running well(enough), the pain is present but barely registers in my consciousness. When non-physical tasks are a chore &/or I am depressed, they burn hotter than the sun. Physical activities seem to be the only remedy to abate it. I've found nothing beyond exercise relieves the pain when it's lit up: anti-inflams / pain killers don't do anything, chiropractors didn't help and imaging indicated no trauma to my spine. Perhaps it's some sort of arthritis or psychosomatic reminder, IDK, it's just another item on my 'getting old sucks' list.
- hesdeadjim 5y ago
  I’ve had far too many injuries in my life due to enjoyment of adrenaline sports, and like you exercise is the only thing that seems to clear out the pain. Funny enough, letting my six year old beat the crap out of me while wrestling with her has been some of the best PT I’ve had.
foamswimsuit 5y ago
That describes exactly the neurological theories and approach of the physical therapy office I go to. The idea is that after traumatic events, the brain can recalibrate its pain registration threshold. Through the process of pushing to the edge of that boundary (and just barely beyond), over time it teaches your brain to reset back to a normal level. I have been to many physical therapists and this was very unique and compelling for me, and several months in I am on a good path.
5y ago

mkl95 5y ago

I have chronic back pain. So far, several doctors agree that the symptoms are there, but none of them have been able to identify the cause. Pain and the mobility issues that come with it sometimes disappear briefly, for an hour or so. I know it sounds crazy, but sometimes I can make the pain go away by focusing on it. None of it seems to make sense.

gameswithgo 5y ago
andai 5y ago
Maybe it's like a messaging system. When you read the message, the notification goes away.
- babyshake 5y ago
  Pain usually doesn't work this way. It's relatively stateless, as in as long as there is a problem in a part of your body you'll feel pain associated with it, and it's not like the pain goes away once you ack it.
wise0wl 5y ago
This is not surprising. Pretty much anything that we experience subjectively can be affected by willful projection of our mental intention. Placebo effect is another name for this phenomenon. Meditative states and specific focus in those meditative states can cause cessation of pain, states of euphoria, tingling, out-of-body sensations, etc.
- garciasn 5y ago
  I have intermittent (usually bi-annually) severe back pain stemming from what has been determined by MRI as a congenital/hereditary narrowing of the spine that causes muscle spasms and long-lasting pain. I'm currently in one of my bi-annual cycles and this one is particularly nasty. 800mg ibuprofen + 1500mg of acetaminophen + 10mg cyclobenzaprine every four hours was doing absolutely nothing for the symptoms. I ended up trying every other remedy under the sun including epsom salt baths, Tiger Balm, etc., for relief. What worked? CBD balm. I don't believe in anything that can be attributed to the placebo effect and that's what I consider remedies like CBD balm. But, it worked and I am going to run w/it. I wish it were easier than me having to fork over $30 for snake oil to trick my body into a positive response but here we are.

lkrubner 5y ago

Based on personal experience, my sense is that much back pain is caused by bacteria. Obviously some people have a specific injury that causes their back pain, but I think doctors have an easier time finding the problem, when there was a specific injury. But when the pain slowly appears with aging, and has no specific cause, I suspect bacteria plays a role. As an analogy, most cases of pneumonia are caused by streptococcus pneumococcus, and most of us have this bacteria in our lungs by the time we are 5 years old, and yet the bacteria lives in our lungs for most of our lives, and it does no damage, so long as our immune system is healthy. But then one day, when we are 85 years old, the streptococcus pneumococcus becomes active and hurts us. This is after 80 years of peaceful coexistence. At one point I was looking up incidence of disease on the CDC website, and I was surprised to see that they said 1 out of 3 Americans test positive for exposure to neisseria meningitis, which can cause spinal meningitis. Only about 55 Americans a year die from this, so this is a bacteria which apparently reaches 100 million Americans but causes death in less than 0.000000001% cases. But maybe it can cause back pain? Maybe as we get older, and our immune system is less active, neisseria meningitis could cause inflammation in the spine? I once had an illness that doctors thought was Lyme disease. Among other things, it gave me agonizing back pain, so bad that I would have to lie on the couch all day, unable to move. But antibiotics fully resolved the situation. So the fact that bacteria can cause back pain is well known to me, and the fact that antibiotics can solve back pain, in some cases, is also well known to me.

lkrubner 5y ago
I’m curious why this was downvotes?
meristohm 5y ago
I had a deer-tick bite a while back, though the two tests for tick-borne illness came back negative. Coincidentally my back pain (which I'd had already) became more acute. I don't know if it was causative, and it seems more likely that it was stress and other factors, but I keep this story around just in case.

not2b 5y ago

Assuming that this is a real effect, it seems that the causality could be in either direction: perhaps atrophy in the brain contributes to pain, or perhaps constant pain causes the pain-related regions of the brain to atrophy.

glouwbug 5y ago

Start deadlifting in your 20s and 30s and you'll do just fine

joeman1000 5y ago
Any resources on this? I’m interested. I’ve tried stretching, cycling, hot baths & a stand-up desk. I messed mine up diving off a boat 8 years ago.
- glouwbug 5y ago
  Strong Lifts. The app is free. 3x a week
reducesuffering 5y ago
Personally, it's squats that make any back pain starting go away like clockwork.