Background & Aims
According to the Global Burden of Diseases (GBD) 2021, the global prevalence of low back pain was estimated to be 619 million cases, representing approximately 7.9% of the total global population and being the greatest contribution to the global disability (1). More than ninety percentage of the patients with acute low back pain are reported to recover the pain and function within a few days to a week, if properly managed (2, 3). A systematic review on prognosis of low back pain reported that there was a 58% decrease in low back pain after first month, and continued to decrease till three months (3). On the other hand, between 3–10% of people develop chronic pain following an acute episode of low back pain (3). A large majority of these individuals who develop chronic pain do not respond to therapy, continue to experience severe levels of pain, have substantial functional limitations, and become emotionally altered as a result of their suffering. In recent years, advancements in neuro
Methods
These systematic reviews adhered to the established guidelines by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist (46). The review protocols were registered and are available under the PROSPERO ID CRD42023433032, and PROSPERO ID CRD42023439124.
Literature searches were undertaken until 07-12-2022 on Medline (Ovid), Cumulated Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Allied and Complementary Medicine Database (AMED), and Psycinfo.
A comprehensive search strategy was used to perform the literature search on electronic databases. The search strategy consisted of two components, namely the condition-related keywords and outcome measures-related keywords. The condition-related keywords were adapted from previously published systematic reviews (47, 48), while the outcome measures-related terms were developed with the aid of previous systematic reviews on neuroimaging a
Results
The literature search yielded 3357 records, and after screening based on the eligibility criteria, 20 articles were included in the first review, comparing the brain changes in CLBP in comparison with healthy controls. Seven studies were included in the second review investigating if these brain changes are reversible after any treatment. Most of the included studies were free of methodological bias and found to be high quality in nature.
The review comparing the structural and functional brain changes in CLBP in comparison with healthy controls identified structural and functional differences in the brain of CLBP patients in comparison with healthy controls. The structural changes includes, smaller thalamus volume (54), and reduced nucleus accumbens volume (54, 55) in CLBP. As well as increased gray matter volume in bilateral postcentral gyrus (56) and in left anterior cingulate cortex (57), were reported in CLBP patients. One study found no difference in any of the cortical or sub
Conclusions
Functional and structural brain changes were observed at various brain regions and networks of CLBP patients in comparison with healthy controls. Studies also reported that certain treatments such as acupuncture, pain reprocessing therapy, carbidopa/levodopa administration, osteopathic manual therapy were able to reverse these brain changes after the treatment. Studies reported that, there was no significant differences between Lidocaine treatment and placebo, as well as no treatment and placebo, in reversing the functional connectivity of the brain in CLBP in comparison to the pre-treatment stage.
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Presenting Author
Muhammed Rashid
Poster Authors
Topics
- Assessment and Diagnosis