Abstract:

Central plasticity resulting from chroniclow back pain in degenerative disorders of the spine Previous findings have shown that intervertebral disc herniation can occur in people who are asymptomatic. However, much effort has been expended to identify prognostic variables based on the classification of the magnetic resonance imaging (MRI) of the spine. Unfortunately, no factor has yet been revealed that reliably distinguishes between patients who should be treated conservatively and those who would instead benefit from surgery. In fact, only a weak correlation has been observed between the size of the prolapsed disc and the presence of clinical symptoms. Since it is the brain that ultimately interprets pain, the neuroscientific community has in recent years increased its focus on studying pain-induced cerebral alterations. And indeed, the adult human brain has an astonishing capacity for the morphological alterations that follow the learning and adaptation processes necessary to a changed environment. Dr. Michael Luchtmann (Otto-von-Guericke-University Magdeburg, Germany) showed that until recently, chronic pain was thought to be associated with abnormal nociceptive function but an unchanged brain structure. Now, however, a large body of new evidence supports the idea that chronic pain not only signals an altered functional state but is also a consequence of central plasticity.