I ran into this article this morning in a newsletter I receive. This is scary. The heading of the article was from the Spinal Injury Foundation and the link takes you to the article at Entrez Pub Med. - National Library of Medicine. I'm not sure the link within the paragraph will carry over when I copy and paste, so I will add it at the bottom of the article also.

"A Hole in the Head and Back Pain"

Anyone who treats chronic pain patients or lives with one will tell you that pain can have a major impact on cognition, attention, and focus. However, a recent study has expanded our understanding in very unexpected ways. Apkarian studied the brains of patients with chronic low back pain with a special MRI technique. He tracked the size of certain parts of the brain across one year. What he found is astounding. Two areas of the brain that help to control pain (Thalamus and Prefrontal Cortex) were shrinking at a rate of 10-20 times normal aging!

What does this mean? All of our brains shrink a little as we age. These two areas are involved in the perception and control of pain signals. What may be happening is that they may literally be wearing out, much like a pancreas wears out from producing too much insulin in a type II diabetic.

This new finding may help explain why many chronic pain patients have difficulty controlling or modulating pain signals. Other research has shown that huge areas of the brain light up in pain patients when even small areas are provoked.

These new findings taken with other studies by the same author argue for much more aggressive treatment of those in pain. In addition, when they say, Its all in your head, they're right!

Christopher J. Centeno, M.D.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retri...=15548656&query_hl=7

Thanks, great find. I tried helping out at one of my Vet's office yesterday standing for 2 hours learning how to answer phones/simple computer stuff... my back was really bugging me at the 2 hour mark, and today not only does my back hurt greatly, I have a Migraine!!!!! So my shrunken brain is probably going into overdrive trying to handle the two.. time for meds/bed (just got up)..

Very interesting! My response when told that my pain is all in my head will be, "It's now in my head because it started in my back." Maybe we can all cite this article and study. It would be interesting to learn more follow-up data.

I find this stuff really scary as it suggests to me that however much surgery one has it may never be possible to get rid of ones pain. But a few months ago I came across this article from New Scientist Magazine vol 182 issue 2445 which may be of interest to some of you.

Controlling pain by watching your brain
New Scientist - 01 May 2004

IT COULD be bad news for the makers of painkillers. A small study suggests people can learn to suppress pain when they are shown the activity of a pain-control region of their brain. This new biofeedback technique might also turn out to be useful for treating other conditions.Biofeedback techniques based on electroencephalogram (EEG) recordings of brainwave patterns, in which electrodes are placed on the scalp, are used with some success to treat epilepsy and attention problems such as ADHD. But no one has found a way to use this method for controlling pain in people, says Peter Rosenfeld of Northwestern University in Chicago, one of the pioneers of biofeedback.Twenty years ago Rosenfeld found that he could change the pain threshold in mice by training them to alter their brainwave patterns through a process called conditioned learning, where an altered brainwave state was rewarded by direct stimulation of the reward centres in their brains. Since this meant placing an electrode into the brain, however, his team never tried the technique on people.Now Fumiko Maeda, Christopher deCharms and their colleagues at Stanford University in California have tried showing people real-time feedback from a functional magnetic resonance imaging (fMRI) scanner. The difference between EEGs and fMRI, says Rosenfeld, is that fMRI allows you to show volunteers how much activity there is in specific areas of their brains. "From scalp recordings, you don't really know what you are recording," he says.The eight volunteers saw the activity of a pain-control region called the rostral anterior cingulate cortex represented on a screen either as a flame that varied in size, or as a simple scrolling bar graph. This brain region is known to modulate both the intensity and the emotional impact of pain.During the scans the volunteers had to endure painful heat on the palm of their hand. They were asked to try to increase or decrease the signal from the brain scanner and to periodically rate their pain sensations.It took just three 13-minute sessions in the scanner for the eight volunteers to learn to vary the brain activity level, and thus to develop some control over their pain sensations, the researchers reported at the Cognitive Neuroscience Society meeting in San Francisco last week.The effect seemed to last beyond the sessions in the scanner, although the researchers have yet to determine how strongly and for how long. The volunteers could not explain how they did it.The researchers ruled out other explanations for the effect through a series of controls. They gave people false feedback data, no feedback at all, or feedback from a part of the brain unrelated to pain control. They also sometimes asked people to pay attention to the pain or distracted their attention away from it.The technique might prove useful not only for training patients to control pain, but perhaps also for treating other illnesses where brain activity is altered, such as depression or dementia. It might even help boost normal brain function. It could also prove a valuable research tool, helping establish links between specific patterns of brain activity and behaviour. But its use is likely to be limited by the high cost of fMRI scanners.