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Where Pain Lives

Fixing chronic back pain is possible only when patients understand how much it is produced by the brain, not the spine.

Cathryn Jakobson Ramin

Aeon, 2017

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You and a friend both get MRIs of your spines, and both reveal bone spurs, ruptured discs and spinal degeneration. You are incapacitated by back pain, but your friend springs up from bed every morning with the vigor of a 20 year old. It turns out that there’s little correlation between spinal imaging results and chronic back pain. And unfortunately for you, traditional treatment options offer limited relief. getAbstract recommends Cathryn Jakobson Ramin’s smart, engaging essay to readers who suspect that “the reign of pain is mainly in the brain,” or to those who deny it.

Summary

Back pain that persists after the initial injury has healed originates in the central nervous system and is a “neurobiological learning disorder.”

Spinal imaging results have little correlation with a patient’s experience of pain. Two people might obtain similar imaging results but feel different levels of pain. Chronic back pain is like a “neurobiological learning disorder” that resides mostly in the central nervous system, not in the back itself. When a pain response to an injury lingers long past the point of usefulness, doctors often suggest that patients be cautious about using their backs. But sufferers might develop “fear-avoidant behavior” that weakens back muscles...

About the Author

Cathryn Jakobson Ramin’s work has appeared in The New York Times, Scientific American and NPR. Her book Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery came out in 2017.

Where Pain Lives

Fixing chronic back pain is possible only when patients understand how much it is produced by the brain, not the spine.

Read or listen offline

Editorial Rating

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Recommendation

Summary

Back pain that persists after the initial injury has healed originates in the central nervous system and is a “neurobiological learning disorder.”

About the Author

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