The vast majority of people will experience back pain at some point in their lives. In up to 40% of adults, back pain becomes chronic or recurrent; however, the underpinnings of pain chronification are poorly understood. Now, a new PET study evaluating dopamine and opioid signalling has demonstrated that patients with chronic non-neuropathic back pain (CNBP) show reduced dopamine receptor binding potential in the striatum. Moreover, a pain challenge (intramuscular injection of hypertonic saline) was linked to a further decrease in dopaminergic signalling via reduced dopamine release in patients with CNBP relative to healthy controls. CNBP was also associated with altered μ-opioid-receptor-mediated antinociception in the amygdala, supporting the notion that dopamine–opioid interactions in the brain are involved in the pathophysiology of chronic pain.
https://www.nature.com/articles/nrneurol.2015.135
https://www.nature.com/articles/nrneurol.2015.135