Sunday, May 22, 2011


You may have heard of or read the book, Change Your Brain, Change Your Life, by psychiatrist Daniel Amen, M.D.   Without getting into specifics, the book deals with what Dr. Amen believes are measurable improvements in brain function and morphology (form and structure) that are possible after a special test (a SPECT scan) and customized treatment.  The treatment is used for addiction, depression, ADHD and many other conditions.   I think most people would find it sensible that treatments tspecifically intended to improve the brain can positively affect many things.  But would you have imagined that successfully treating back pain could also improve brain function?   It might be surprising to you that those with chronic back pain have problems with the ability to think, concentrate, formulate ideas, reason and remember.  They lose brain gray matter in parts of the brain associated with pain processing and the emotional components of pain, like depression and anxiety.  More surprising might be a recent finding that when back pain improves, brain function improves, including thickening previously thinned brain cortex.

In a study published this week, May 2011, in the Journal of Neuroscience, a group of pain researchers from McGill University and the McGill University Health Centre found that when patients’ chronic low back pain was alleviated, there was improvement in brain abnormalities.
Patients who had low back pain for more than six months underwent MRI scans to measure cortical thickness of the brain as well as brain activity when the subjects were asked to perform a simple task.  The MRIs confirmed brain abnormalities as noted previously.

After successful management of the chronic back pain, the research team not only observed recovery in the anatomical function of the brain, but also in its ability to function.  After the subjects were treated, researchers did MRIs again and found increased cortical thickness in specific areas of the brain that were related to both pain and physical disability.  The abnormal brain activity that was previously observed during an attention-demanding cognitive task was found to have normalized after treatment.

One of the researchers, Laura S. Stone, said, "If you can make the pain go away with effective treatment, you can reverse resume his there who were these abnormal changes in the brain." 

While more research is needed to confirm this study, these findings fit my experience; many people who suffer with chronic pain have to deal with increased stress, poor sleep, difficulty making decisions, anxiety, depression and family problems. Successfully treating their pain, of course, make the stress and related problems go away or become much less of a concern. 

Most people in pain have had the all too common experience of finding that stressful situations increase pain. Unfortunately, our body is designed for this reaction. Through a process that is referred to as Fight or Flight, stressful situations lead to several temporary biological events that are meant to protect the body. If you are in immediate danger, this system works quite well. If the stress is prolonged, the effects on health can be damaging. Part of the response to long term stress may be a sustained increase in certain hormones, like cortisol, and inflammatory chemicals, such as cytokines, that can make pain worse and slow or stop your body from recovering from pain and injury.

Pain itself is stressful as are accompanying problems like missing work, not being able to travel, etcetera. Pain and stress can become a vicious cycle.  Prolonged stress is well known to have bad effects on the hippocampus, which is an important part of the brain associated with forming, organizing and storing memory.  Chronic pain can also disrupt brain function in what is called the Hypothalamo-Pituitary-Adrenal Axis or HPA which can have various, profound health consequences.

What is the bottom line?  Treatment of chronic spinal pain, if successful, can improve mood, memory and specific brain function. 

If you suffer from persistent spine pain, eliminating or controlling it looks like it can improve brain function too.  

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