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When a Back-Pain Flare Hits, the Brain’s “Sense of Self” Network Lights Up
A brain-imaging study of 114 adults with chronic low back pain found that pain triggered by movement engaged a network usually linked to self-reflection — not just the regions that register pain.
This article is general health information written by our editors from the sources listed below. It has not yet been medically reviewed — see our medical review policy. It is not advice for your situation.
For someone living with chronic low back pain, the hardest moments are rarely dramatic. They are the ordinary ones: reaching for a bag, bending to pick up a shoe, getting out of a car. The pain is always there in the background; a movement turns it up. Researchers at the University of California, San Diego wanted to know what happens in the brain during exactly that kind of flare.
What the researchers did
The team recruited 114 adults whose low back pain had lasted at least three months. Each person had a functional MRI scan, which tracks changes in blood flow as an indirect measure of brain activity. A researcher then raised the participant’s leg until their back pain increased, held it for ten seconds and lowered it; a second scan followed immediately. On average, the manoeuvre raised reported pain intensity by about 23 per cent. For comparison, participants also had a painful heat stimulus applied to the calf — a standard way of studying short-lived, or acute, pain.
The study was published on 5 October 2026 in the British Journal of Anaesthesia and reported by Live Science on 14 October.
What they found
As expected, the leg raise increased activity in regions that process pain and movement. The surprise was elsewhere. Movement-triggered back pain was associated with more activity in parts of the default mode network — a set of connected regions that is usually busiest when people think about themselves, recall personal memories or let their minds wander. In studies of acute pain, that network typically becomes less active, and the heat test in this study behaved that way. The researchers told Live Science they re-checked their analysis several times because the result was so unexpected.
Participants who reported more severe chronic pain also showed stronger connectivity between the default mode network and regions that process sensation from the back. The authors’ interpretation is that long-standing pain may become woven into how a person experiences their own body, rather than being registered only as a signal from the painful area.
Why it matters in everyday life
Many people with persistent pain describe something that does not show up on an X-ray: the sense that pain has become part of who they are, colouring how they move and plan their day. This study offers a possible biological picture of that experience. It also points to a different kind of treatment target. If flares involve networks concerned with self-perception, approaches that change how a person relates to their pain — rather than only treatments aimed at the painful tissue — may deserve more attention. The research team is already investigating whether mindfulness meditation or cognitive behavioural therapy influence this network. Cognitive behavioural therapy for chronic pain is already an established treatment option.
What this does not establish
- It is an observational imaging study. It shows an association between movement-triggered pain and a brain pattern; it cannot show that the pattern causes chronic pain or that chronic pain causes the pattern.
- Katherine Martucci, a Duke University neuroscientist not involved in the work, told Live Science the post-movement scans could also reflect lingering pain or anxiety after the leg raise, and that it is too early to say how the findings might be used in clinical practice.
- Nothing in the study tested a treatment. It does not show that any therapy works better because of these findings.
- The results come from one group of 114 people with low back pain; whether they apply to other pain conditions is unknown.
Questions you might discuss with your clinician
- Which movements set off my flares, and are there ways to approach them that reduce the fear and bracing that often come with them?
- Would a psychologically informed approach — such as cognitive behavioural therapy for pain or a mindfulness programme — fit alongside my current treatment?
- What is the plan for my pain overall, and how will we tell whether it is working?
Treatments offered at SEVA Healthcare for back and neck pain, including image-guided injections and radiofrequency ablation, are listed on our Back & Neck Pain page with a link to the official SEVA Healthcare service page.
Frequently asked questions
What did this study measure?
Researchers scanned the brains of 114 adults with low back pain lasting at least three months using functional MRI, before and right after a leg raise that increased their back pain. On average, the leg raise raised reported pain intensity by about 23 percent.
What was surprising about the results?
Movement-triggered back pain was associated with more activity in the default mode network, a set of regions usually busiest when people think about themselves or let their minds wander. In studies of acute pain, that network typically becomes less active, and the heat test in this study behaved that way.
Does this study show that a particular treatment works?
No. Nothing in the study tested a treatment, and it does not show that any therapy works better because of these findings. The research team is investigating whether mindfulness meditation or cognitive behavioral therapy influence this network.
Does this mean the brain pattern causes chronic back pain?
No. It is an observational imaging study that shows an association, and it cannot show that the pattern causes chronic pain or that chronic pain causes the pattern. An outside expert also noted it is too early to say how the findings might be used in clinical practice.
Sources
- Chronic pain may become intertwined with how people perceive themselves, brain scans suggest — Live Science (Jennifer Zieba), 2026-10-14
- Gianola M, Dean J, Chen C, et al. Brain mechanisms supporting movement-evoked chronic low back pain: an observational brain imaging study — British Journal of Anaesthesia, 2026-10-05
- Study DOI: 10.1016/j.bja.2026.08.010
This article is sponsored content by SEVA Healthcare and is for general information only — it is not medical or legal advice. Treatment options depend on an individual evaluation, and results vary from person to person. In an emergency, call 911. Spotted an error? See our corrections policy.
