Brain damage in certain areas has been seen in chronic back pain, Complex Regional Pain Syndrome, Fibromyaglia, and so on. The question is whether the damage causes the pain or visa versa. In hip pain patients, the at least partial resolution of this atrophy following successful hip surgery suggests the pain causes the damage.
- 32 cases of chronic Osteoarthrtis of hip showed “a characteristic gray matter decrease in:
- anterior cingulate cortex (ACC) – chronic pain center
- right insular cortex and operculum – pain severity monitoring centre
- dorsolateral prefrontal cortex (DLPFC) – happiness and hence depression centre
- amygdala – emotional home
- brainstem – pain relay station
- 10 cases were followed post hip surgery and demonstrated “a gray matter increase in the DLPFC, ACC, amygdala, and brainstem”
- Their conclusion was that ” As gray matter decrease is at least partly reversible when pain is successfully treated, we suggest that the gray matter abnormalities found in chronic pain do not reflect brain damage but rather are a reversible consequence of chronic nociceptive transmission, which normalizes when the pain is adequately treated.”
Comment – Given that brain damage in the DLPFC will cause depression (seen in subjects treated with Inferon injections for Hep C treatment), it can be concluded that the depression seen in chronic pain is more likely the response to chronic pain, albeit those with depression tendencies are likely to fall prey to it faster.
The idea that someone with chronic pain is just depressed and hence not covered by insurance is just not defendable anymore.
Any comments?
EH DOC, what about all the BRAIN DAMAGE that WCB causes with their psychopathic corporate “Culture of Denial”.
FYI:
In 2006 I found an Internet Website called http://www.coccyx.org as I suffered a severe tailbone injury. I took this information to the physician who was providing the medical treatment for my work injury. He sent me for one of the tests called a sit/stand dynamic x-ray. Of course no one in this province would or could do it.
In desperation, I sent all the info to my wcb claims adjudicator and asked to have it forwarded onto the WCB medical advisor. His reply was quote,
“”There are 14,000,000 million websites on the internet stating the EARTH IS FLAT, so this shows you can’t believe everything on the Internet.
In desperation for relief, I decided to go to Seattle for the specialized FONAR MRI as there were reports that stated this positional MRI machine can diagnose spinal pathology of INJURY that is frequently missed in recumbent MRI machines.
After many calls to Seattle MRI and multiple visits to this physician here in Sask who I had told I thought I had coccydynia, provided all evidence…supplied by wwwcoccyx.org and the info from FONAR, I thought everything was good to go.
He filled out the requisition for what I had requested, a MRI of my spine from my cervical to the tip of my tailbone, I figured as it took 28 Saskatchewan Doctors to diagnose my broken back / and even though my 1st physician stated I had a fractured tailbone, which of course WCB disputed, better to be on the safe side and gert everything done, as I am in severe pain;
I flew to abbotsford, rented a car, and with my 30 minute driving privilege afforded me by SGI, I made my way to Seattle all drugged up in pain.
I was refused the MRI for the investigation of coccydynia, so I didn’t bother with anything else as I BLEW A GASKET; Which proves that physicans can’t even order a test right; LONG STORY SHORT in Dec 2009 I was diagnosed with coccydynia after being examined by 3 neurosurgeons who missed it, and 5 ortho surgeons who missed it, WHY ARE DOCTORS NOT PERFORMING COMPLETE PHYSICALS?
So now the pain specialist states that, likely due to the chronicity I likely have developed neuropathic pain, which I probably have because I am literally crawling in my skin as the pain is ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
PAIN;
NO WONDER NOBODY IN THIS PROVINCE TRUSTS PHYSICIANS OR WCB;