2004-08-13 / Columnists

Eye On Physical Therapy

By Dr. Tim Rohrs

According to an article in the New York Times , back pain is listed as the eighth leading reason for people to visit their physician. Millions are spent each year on the prevention and treatment of back pain. Whole medical journals are dedicated to the research of the cause of back pain and treatments. It’s possible that everyone has been looking in the wrong direction to find the answer. Recent research may ultimately prove that your back pain really is in your head.

Researchers from Georgetown University performed a study that looked at the way the brain processes pain signals. The results published in Arthritis and Rheumatism , suggest that back pain sufferers and patients with fibromyalgia reported pain at relatively low pressure pain thresholds compared to a control group. “The pressure required to produce slightly intense pain was significantly higher in the controls that in the patients with chronic low back pain or fibromyalgia” according to the researchers.

While testing, not only was the pain pressure response and the degree of tenderness the participant experienced measured, the researchers used MRI to look at brain activity. They found that the heightened pain responses translated into a distinctive pattern of activity in areas of the brain involved in pain processing. Daniel Clauw, M.D. reports that “For some reason, still unknown, there’s a neurobiological amplification of their pain signals”.

The researchers are quick to point out that this is a preliminary study and does not support broad generalizations.

They expect similar types of larger studies and with different clinical populations. In addition, if the research does point to abnormal processing of pain signals in the brain, they believe treatment will change also. According to Dr. Giesecke, the chief researcher, “Some patients with back pain related to abnormal pain processing might benefit from treatments believed to affect pain processing, e.g. trycyclic antidepressants, aerobic exercise and cognitive therapy.”

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