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Low back pain is the single leading cause of disability worldwide, according to the World Health Organization. For people with chronic low back pain (cLBP) lasting more than 12 weeks, a sudden pain flare triggered by movement can often worsen the condition. Pain signals originate in the brain, but scientists still don't fully understand the specific neural circuitry that sparks this movement-based pain.

Now, researchers at UC San Diego School of Medicine have found that the brain's default mode network (DMN) is turned on when cLBP patients experience sudden pain brought on by movement. The DMN is also referred to as the "self network" because it is associated with interconnected regions of the frontal, parietal and temporal lobes of the brain that become active when we are thinking about ourselves and our identity or reflecting on internal thoughts and feelings—rather than focusing on the outside world.

The study, published in the British Journal of Anaesthesia, could help explain why typical symptom-based treatments are often ineffective and suggests that targeting the brain's DMN may be a better approach to managing cLBP.

The researchers had 114 cLBP patients perform a "leg raise test"—a standard way to trigger a back pain flare—while they measured blood flow in the brain using a specialized functional MRI technique called arterial spin labeling. As a control, they also tested how the patients' brains responded to a harmless but painful heat stimulus on the calf, comparable to accidentally touching a hot stove.

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