Brain Circuitry and Chronic Back Pain

The pain is not in your head

Many people feel like their doctor is saying that they are making up their pain. Your pain is not imaginary. You are not doing this to yourself voluntarily! But after the spinal cord receives the signals from the muscles, it does send signals to your brain. Your best asset to deal with chronic pain is still your brain.

What initially started as a harmless signal in the muscles, your spinal cord has amplified into a loud alarm that your brain now has to figure out the meaning of. This is where your thoughts and emotions can play an important role in managing your pain. Even if your spinal cord has amplified a minor achy pain into unbearable pain, it is up to your brain to override these signals.

Factors that influence your pain

Did you know that your pain intensity can increase if you live in a stressful environment? Some conditions like chronic pain, anxiety, and depression all activate similar parts of the brain. Certain parts of the brain are linked through different biological and electrical circuits.

We also know that untreated depression can increase medical symptoms, decrease a person’s pain threshold, and increase the intensity of pain. Up to 70 percent of people consulting a doctor about depression also have physical aches and pains. Musculoskeletal pain, depression, and anxiety are so strongly linked that health-care providers should be on the lookout for all three.

Many people believe that if doctors can get rid of the physical pain, then depression and/or anxiety will also go away; however, there has been no clinical or research evidence that treating only a person’s pain gets rid of depression and/or anxiety.

Depression, anxiety, and your pain

Many people who have been prescribed the most powerful opioid medications seem to have much increased depression and pain. In fact, this approach commonly leads to misdiagnosis, frustration, and overtreatment of non-painful, age-appropriate, structural abnormalities in the spine. Not all patients with scoliosis or abnormally curved spines have chronic pain.

Spine researchers also think that some people who have a history of depression, stressful life events, anxiety, considerable fears, or catastrophic thinking or misunderstandings of their pain may have increased sensitivities. Some researchers also believe that the concept of mental defeat or when people feel that their pain has taken away all of their self-reliance and identity is what finally drives them to see a doctor.

It is also known that injured workers with a combination of pain, depression, and anxiety are out of the workforce much longer than those who complain of pain alone. Because pain, anxiety, and depression are so interconnected, we can take advantage of treatments for all of these conditions.

We know that depression and anxiety can be treated successfully with medications and cognitive behavioral therapy. All of these conditions, if left untreated, are likely to lead to overstimulation of the spinal cord and brain starting the central amplification process. Even with all of the advanced medical imaging and testing available to us today, we still cannot analyze your spinal cord or brain to block these signals in any meaningful way.