Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain

Tomography. 2022 Aug 25;8(5):2153-2163. doi: 10.3390/tomography8050180.


Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders, being one of the leading contributors to disability worldwide and involving an important economic and social burden. Up to 90% of CLBP is non-specific (not associated with specific injuries), with a chronicity expectation estimated at 10%. Currently, motivational and emotional central circuits are being investigated due to their role in CLBP persistency and chronification. Therefore, this narrative review aimed to summarize the evidence regarding the cortical brain changes described for proposing novel multidisciplinary approaches. Novel advances in neuroimaging techniques demonstrated structural (e.g., decrease in the grey matter located at the dorsolateral prefrontal cortex), functional (e.g., connectivity impairments in those areas involved in pain processing), and neurochemical changes (e.g., decrease in cerebral metabolites). In addition, significant changes were found in the primary somatosensory and motor cortex, contributing to the alteration of low back muscles activation and function.

Keywords: chronic pain; cortical brain changes; low back pain; neuroimaging; neuroscience.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Humans
  • Low Back Pain* / diagnostic imaging
  • Low Back Pain* / psychology
  • Magnetic Resonance Imaging / methods
  • Motor Cortex* / diagnostic imaging

Grants and funding

This research received no external funding.