While most people will experience low back pain at some stage in their lives, Chronic Low Back Pain (CLBP) is persistent pain that may last for many years. In addition to the physical and emotional discomfort, research is now suggesting that CLBP may also be related to atrophy (shrinkage) of brain tissue.
In a study, published in the Journal of Neuroscience, the brain grey matter density in 26 patients with CLBP was compared to 26 pain-free controls. Patients in the pain group had experienced unrelenting pain for more than a year, primarily at the base of the spine. Structural brain magnetic resonance imaging (MRI) studies showed that patients with CLBP had 5-11% less cortical grey matter volume than did pain-free controls. This was noted especially around the prefrontal cortex of the brain, which is believed to control pain perception.
These findings document, for the first time, changes in the cerebral cortex of patients with unrelenting back pain. The authors noted that it would take an average pain-free person 10 to 20 years to lose this much grey matter in the process of aging.
Possible Causes
But what reduced the grey matter? Several causes have been proposed.
Genetics: some people who were born with less grey matter than normal, may be predisposed to CLBP.
Drugs: medications and other substances taken to alleviate pain might also reduce grey matter. Excessive alcohol and opioid (pain killer) use have long-term adverse effects on the central nervous system.
Overuse atrophy: the researchers propose that cortical brain loss may be secondary to overuse. They suggest that persistent pain perception – and the resultant stress and negative affect – stimulates the brain beyond its metabolic capacity. If this is true, then chronic pain itself causes cerebral atrophy.
How Chiropractic Can Help
Chiropractic care focuses on restoring spinal balance. Adjustments to the spine activate sensory nerves that fire into the spinal cord and on to the brain. In particular, the lower part of the brain, known as the cerebellum, is frequently activated with chiropractic techniques. Through connections in the brain, spinal adjustments may improve the ability of the brain to put the brakes on pain. Through the effects on the cerebellum - posture, spinal stability and even learning may improve.
In addition to direct care, chiropractors advise patients to do particular core stability exercises that can support the spine. Breathing exercise to ensure proper functioning of the diaphragm and cerebral oxygenation is important – the brain is particularly susceptible to decreased oxygen levels. In some cases, nutrients that nourish the nervous system, such as omega 3 fatty acids and CoQ10, may be recommended.
