Pain Can Have a Neurological, Not Physical, Cause

Pain and the management of pain are topics that are, increasingly, garnering more interest and more attention, both by the general population and by researchers. This is simply due to the fact that medical science has now advanced to the point where it may be possible to find answers to questions regarding pain that, till now, have eluded us.

Pain. Is it all in your head? Back pain does not always have an apparent physical cause, and findings from researchers at the University of Michigan suggest the brain may be to blame. The study sample included 15 patients with lower back pain that had no physical reason such as disc or muscle problems, 15 fibromyalgia patients and 15 healthy people with no back pain. The researchers looked at brain scans while applying pressure as rapid pulsing to the base of the left thumbnail.

Like patients with mysterious back pain, fibromyalgia patients experience pain in the muscles, ligaments and tendons that can not be attributed to a specific physical problem. Research on the condition shows that abnormalities in the central nervous system may be the cause. It is thought that these abnormalities affect regions in the brain and cause or contribute to the pain symptoms.

In all patients with FMS, the brain scans showed increased brain activity in certain areas, but the stimulation patterns were different for each group. Those with fibromyalgia and lower back pain experienced pain feeling when just mild pressure was applied, while healthy patients felt little effect. The researchers believe that the study provides a kind of map that shows which brain regions show the most and the least activity in response to pain.

The findings suggest that those patients with lower back pain experience an enhanced pain response in certain areas of the brain and a diminished pain response in others. It appears that these patients are simply more sensitive to pain from a pathologic process that differs from healthy patients.

Critics of the study, such as Dr Jan van der Merwe, St Thomas’s Hospital (London) head of Input Pain Management, point out that many factors contribute to increases in neural brain activity and that there is no way to tell whether the patients had increased brain activity due to pain sensitivity or from other stimuli, such as thinking about something else. While the study findings suggest that those with fibromyalgia and lower back pain experience a neurobiological amplification of pain signals that other groups do not experience, more research is needed to further demonstrate the evidence of this and determine why the heightened response occurs.

Jack Chanceling is a freelance writer contributing to the Fibromyalgia Feed.

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