About this Research Topic
Low back pain (LBP) is the most common and disabling condition globally, with a point prevalence of approximately 20% and a lifetime prevalence of nearly 80%. While most LBP cases resolve spontaneously after a few days or weeks, some patients will develop chronic LBP, which may lead to severe disability, psychosocial problems, and enormous healthcare costs.
Although the underlying causes of LBP are largely unknown, LBP is not a simple musculoskeletal ailment. A growing number of studies have demonstrated that patients with LBP are associated with multiple neurophysiological changes in the nervous system. Brain imaging research has illustrated immediate changes/reorganization in neural activity of multiple brain regions (e.g. primary somatosensory cortex, prefrontal cortex, anterior and posterior cingulate cortex, insula and cerebellum) in people with experimental LBP. Likewise, some people with chronic LBP are characterized by regional decreases in gray matter density and volume in several brain regions (e.g. dorsolateral prefrontal cortex, thalamus, insula, hippocampus, and/or prefrontal cortex), reduced white matter volume in midcingulate cortex, and/or widespread changes in resting state functional connectivity within the brain. Further, mounting evidence has suggested that patients with chronic LBP may experience disrupted working body schema, suboptimal transmission of proprioceptive signals to the brain and altered motor excitability, which may affect the movement of these patients.
In addition, non-imaging research has revealed that patients with LBP may demonstrate increased 2-point discrimination threshold in the painful region and altered trunk proprioception. Biomechanical studies also highlight that patients with LBP may display selective changes in motor activation strategies of trunk muscles, reorganization in spatial lumbar muscle activity, changes in reflex latency of some trunk muscles following unexpected trunk perturbation, and/or abnormal baseline activity of back muscles.
Collectively, the current evidence suggests that the divergent abnormal LBP-related changes in brain activity and neural structures may be responsible for the distinct alterations in sensorimotor, psychological and/or cognitive functions of patients with acute or chronic LBP. Both researchers and clinicians should broaden their understanding about various LBP-related neurophysiological changes so as to unveil potential mechanisms underlying LBP and to guide the development of novel prevention and treatment strategies. Accordingly, we have initiated a “neurophysiological changes and low back pain” Research Topic. This project welcomes all types of articles (mechanistic studies, systematic reviews, randomized controlled trials, etc.), with the exception of case reports, that provide the latest evidence regarding unique neurophysiological changes in people with LBP.
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.