Pain or No Pain: Paradigm to Image Lower Back Pain with fMRI

Harish A. Sharma¹, Raj Gupta², William Olivero³

Low back pain affects millions of patients. fMRI studies have made significant contributions to the understanding of how the brain processes pain. However, most of the studies have involved normal subjects subjected to painful stimuli during fMRI. Studying patients with acute pain has been difficult because of motion artifact and the difficulty in altering the patients painful experience during fMRI. We elected to study patients with back pain and radiculopathy from a herniated disc using various maneuvers like leg raise, dorsiflexion of the foot and tensing of the muscles of thigh in an attempt to alter the pain perception to determine if we could reliably obtain fMRI images when the patients pain scale rating changed during the maneuvers.