Back Pain And Other Symptoms Of Pain Could Be Caused By Brain Signals

Written by Sophia Randerson on June 24, 2020 — fact checked by Andrea Anita

Pain in your back is unavoidable, but stress and sleep disturbances can certainly exacerbate it. How can you tell if you are feeling those symptoms, and what can you do to alleviate them?

Short sleep duration, irritability, fatigue, and nausea may all be signs of back pain.

After all, if you feel that a painful back is making life uncomfortable, it is best to try to tackle the problem before it becomes unmanageable.

Experts offer advice on how to deal with back pain most effective, including managing pain by exercise, and advice on painkillers.

However, how can patients know if they are experiencing pain in their back, and what can they do to combat it?

Surgery might be the only option. But as recent studies have shown, some surgery may not be as effective as we were first led to believe.

For example, results of a recent study — led by Prof. S. Girish Jha, from the Department of Medicine at the University of Toronto in Canada — showed that postoperative pain in someone with low back pain can significantly worsen within an hour of surgery.

Now, a new study examines what is causing pain in your back, and they may have some unexpected answers.

Prof. Jha and colleagues recently reported their findings in the journal Pharmacotherapy.

'Troubling interference' with pain transmission

Prof. Jha and colleagues analyzed a group of patients with low back pain who had undergone relatively simple stress surgery.

The team assessed how each patient's pain was associated with four symptoms: sleepiness, irritability, fatigue, and nausea.

Using an MRI scanner, the researchers scanned each patient's spine, and they measured the movement and pressure exerted in relation to signals sent via the central nervous system.

They found that the patients with low back pain were significantly more likely to have low expectations of recovery, greater pain ratings compared with an control group of patients, and a greater disruption of nerve signals to the spinal cord.

"[...] A connection between these factors, most notably the absence of a grade-five grade of expected management, was concerning to me," notes Prof. Jha.

Low levels of neuroprotection triggered

Moreover, the researchers pinpointed a previously unknown role for two proteins called Nrf2 and NK cells in causing this "concerted interference" with pain signals.

Prof. Jha explains that the proteins Nrf2 and NK cells help to build up some molecules called cytoskeleton, which are stable until the body needs them to operate.

However, in people with lower back pain, Nrf2 levels are reduced — as is also seen in people with Parkinson's disease.

In addition, researchers have observed that these proteins are suppressed in the peripheral nervous system in patients with spinal cord injury.

Prof. Jha and colleagues hypothesized that these two factors could help to block pain signals going to the spinal cord, meaning that Nrf2 and NK cells could prevent people with low back pain from being more vulnerable to the condition.

The researchers say that more studies are required to demonstrate whether these findings can be replicated in other conditions.

However, Prof. Jha goes on to say that the new findings are consistent with "a variety of studies that have shown the existence of abnormal activity in nerve-centric contexts, either in neurons or peripheral networks."

He concludes:

"Even if patients with low back pain do not get optimal pain relief in the surgical setting, this group of findings suggests that surgical pain may have a more complex origin and more significant implications than we thought."

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Written by Sophia Randerson on June 24, 2020 — fact checked by Andrea Anita

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