Cortical changes in chronic low back pain: current state of the art and implications for clinical practice

Man Ther. 2011 Feb;16(1):15-20. doi: 10.1016/j.math.2010.06.008. Epub 2010 Jul 23.


There is increasing evidence that chronic pain problems are characterised by alterations in brain structure and function. Chronic back pain is no exception. There is a growing sentiment, with accompanying theory, that these brain changes contribute to chronic back pain, although empirical support is lacking. This paper reviews the structural and functional changes of the brain that have been observed in people with chronic back pain. We cast light on the clinical implications of these changes and the possibilities for new treatments but we also advise caution against concluding their efficacy in the absence of solid evidence to this effect.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cerebral Cortex / chemistry*
  • Cerebral Cortex / physiopathology
  • Chronic Disease
  • Humans
  • Low Back Pain / physiopathology*
  • Low Back Pain / rehabilitation
  • Neuronal Plasticity*
  • Pain Threshold
  • Proprioception