Mechanisms behind the Development of Chronic Low Back Pain and Its Neurodegenerative Features

Abstract

Chronic back pain is complex and there is no guarantee that treating its potential causes will cause the pain to go away. Therefore, rather than attempting to “cure” chronic pain, many clinicians, caregivers and researchers aim to help educate patients about their pain and try to help them live a better quality of life despite their condition. A systematic review has demonstrated that patient education has a large effect on pain and pain related disability when done in conjunction with treatments. Therefore, understanding and updating our current state of knowledge of the pathophysiology of back pain is important in educating patients as well as guiding the development of novel therapeutics. Growing evidence suggests that back pain causes morphological changes in the central nervous system and that these changes have significant overlap with those seen in common neurodegenerative disorders. These similarities in mechanisms may explain the associations between chronic low back pain and cognitive decline and brain fog. The neurodegenerative underpinnings of chronic low back pain demonstrate a new layer of understanding for this condition, which may help inspire new strategies in pain education and management, as well as potentially improve current treatment.

Biomechanical Effects of Different Sitting Postures and Physiologic Movements on the Lumbar Spine: A Finite Element Study

“…Second, our FEM did not encompass muscles, tendons, nerves, and ligaments around the lumbar spine, nor did it account for potential structural changes in these elements. The muscles surrounding the spine play a crucial role in stabilizing the spinal structures and alleviating stress on the spine [ 48 , 49 ]. Notably, the collective cross-sectional area of the numerous muscles encircling the spinal column far surpasses that of the spinal column itself.…”

Exercise-induced neuroplasticity: a new perspective on rehabilitation for chronic low back pain

“…Elderly patients with CLBP are affected by both back pain and natural aging. Research has found that CLBP presents neurodegenerative characteristics such as neuronal apoptosis and decreased gray matter in the brain as the disease progresses ( Mosabbir, 2022 ). Furthermore, CLBP patients have abnormal brain metabolism, which activates neuroglial cells that play a role in immune surveillance, leading to increased release of pro-inflammatory and chemotactic factors, resulting in the appearance of neuroinflammation ( Ji et al, 2018 ; Albrecht et al, 2021 ; Li et al, 2021 ).…”

“…Research has found that chronic pain patients have changes in brain metabolism, which can lead to degeneration of the thalamus and prefrontal cortex. Brain regions such as the hippocampus, basal ganglia, and amygdala can also be affected, and these regions are closely related to memory, movement, and emotion processing ( Mosabbir, 2022 ). Exercise can effectively address the dual impact of aging and lower back pain.…”

The Clinical Efficacy of Platelet-Rich Plasma Injection Therapy versus Different Control Groups for Chronic Low Back Pain: A Network Meta-Analysis of Randomized Controlled Trials

“…1,2 LBP is defined as pain (with or without pain in one or both legs) lasting at least one day, located posteriorly, ranging from the lower border of the 12th rib to the lower gluteal crease. [3][4][5] LBP symptoms can arise from various anatomical issues, including bones, nerve roots, fascial structures, joints, muscles, intervertebral discs, and abdominal organs. 6,7 Precisely defining the source of LBP is impossible for most patients.…”