Can Treating Lower Back Pain Improve Intelligence?
Posted May 19 2013 7:00pm
Chiropractic care is known for its effectiveness in treating back and neck pain. Dr. J G Moellendorf, DC, ND, LCP discusses recent research into chronic spinal pain and how its treatment can effect depression, thinking, and memory.
Patients with chronic back or neck pain often complain of fuzzy thinking, poor memory, and feelings of anxiety and depression. Sturgeon Bay, Wisconsin Chiropractor and Naturopath Dr. J G Moellendorf, DC, ND, LCP points out that these symptoms start in the hippocampal area of the brain, the same region that processes spinal pain signals. Doctors and researchers have often wondered if chronic pain is actually a whole-brain disorder, rather than the pain signaling system gone awry, .
Researchers Amelia A Mutso, A. Vania Apkarian, et al at Northwestern University investigated the underlying cellular and molecular changes that influence behaviors in mice with chronic abnormal nerve pain. Their findings were recently published in a paper titled Abnormalities in Hippocampal Functioning with Persistent Pain in the Journal of Neuroscience.
The hippocampus, which is critical for learning, memory and emotional processing, is one of the few brain regions of mice and men in which new neurons grow. The researchers found that chronic nerve pain in mice causes a failure in new hippocampal neuron growth, disrupts its electrical and biochemical signaling, and results in increased anxious behaviors and difficulties with emotional learning.
Using anatomical brain scans, the researchers measured the hippocampal volume of three groups of humans with chronic pain. The two groups with chronic back pain or complex regional pain syndrome had significantly smaller hippocampal regions, while the group with osteoarthritis had a nearly normal size. The first two groups showed similar symptoms of anxiety, depression, and deficits in learning and memory similar to the mice with chronic pain. The researchers suspect that the reduced hippocampal size in people is the result of the lack in neuron growth and other impairments as seen in the mice. When new neurons do not grow, memory and emotional processes become impaired. The research team headed by Mutso and Apkarian emphasized the importance of locating the source of the chronic pain and providing the proper treatment for a brain-based disorder.
The next question then is: can aberrant brain function be reversed by the proper treatment of spinal pain? A research team led by David A. Seminowicz considered this exact subject in their paper Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function. They looked at the gray matter thickness with structural MRI scans of 18 chronic low back pain patients before surgery or facet joint pain blocking injections, along with 14 patients 6 months after surgery or facet injection. These scans were compared with 16 healthy subjects, 10 of which also returned 6 months later. Functional MRI scans were also done on all of the groups while performing a cognitive task. Those patients with chronic pain had decreased brain gray matter thickness and impaired cognitive ability compared to the healthy subjects.
Six months after successful treatment for back pain, the chronic pain patients displayed increased cortical thicknesses in: the left dorsolateral prefrontal cortex (correlating with reduced pain and physical disability), the primary motor cortex (correlating with reduced physical disability), and the right anterior insula (correlating with reduced pain). The functional MRIs showed abnormal activity in the left dorsolateral prefrontal cortex region during attention-demanding cognitive tasks before treatment, but normal activity 6 months after successful treatment of the pain.
These results indicate that structural and functional brain abnormalities are reversible, indicating that the proper treatment of chronic pain can restore normal brain function in humans. With Chiropractic’s proven results in treating chronic back pain, it would be interesting if a group of Chiropractic researchers would replicate this research study using Chiropractic care.