Brain imaging study reveals treatable link between chronic back pain and hypersensitivity to everyday sounds

CU Anschutz study finds chronic back pain causes brain changes that make sounds feel harsher, but shows Pain Reprocessing Therapy can reverse the effect.

By: AXL Media

Published: Mar 3, 2026, 5:29 AM EST

Source: The information in this article was sourced from University of Colorado Anschutz

The phenomenon of sensory amplification

Clinical evidence has long suggested that patients with chronic back pain experience heightened sensitivity to external stimuli, but a new study published in Annals of Neurology provides the first measurable brain-imaging data to support these claims. Researchers found that people with chronic pain process everyday sounds with significantly more intensity than those without pain. On average, chronic pain patients reacted more strongly to sound than 84% of the healthy control group, suggesting that chronic back pain is a condition that fundamentally alters global sensory processing.

Neurological shifts in sound and emotion processing

Using MRI scans, the research team discovered that the heightened sensitivity does not occur in the primary ear-to-brain pathways, but rather in higher-order brain regions. Specifically, patients showed exaggerated responses in the auditory cortex, which processes loudness, and the insula, which handles emotional sensations. Conversely, activity was lower in the medial prefrontal cortex—a region responsible for calming and regulating emotional reactions. This imbalance indicates that the brain is not only "turning up the volume" on sound but also losing its ability to modulate the resulting unpleasantness.

Effectiveness of Pain Reprocessing Therapy

The study compared three different treatment approaches for the 142 participants with chronic back pain: