Everyday sounds add to the torment of a person with chronic back pain, apparently because pain rewires how the brain responds to noise, a new study says.

People suffering from back pain process sounds differently and more intensely, adding to their agony, researchers recently reported in the Annals of Neurology.

“Our findings validate what many patients have been saying for years that everyday sounds genuinely feel harsher and more intense,” said senior researcher Yoni Ashar, co-director of the Pain Science Program at the University of Colorado Anschutz School of Medicine.

“This tells us chronic back pain isn’t just about the back,” Ashar said in a news release. “There’s a broader sensory amplification happening in the brain, and that opens the door for treatments that can help turn that volume down.”

For the new study, researchers compared 142 adults with chronic back pain to 51 pain-free folks.

All of the participants underwent MRI brain imaging, during which they were asked to perform tasks such as listening to sounds.

On average, back pain patients reacted more strongly to sounds than 84% of people without pain, the study found.

Researchers also found that their brains weren’t having this response in areas that initially receive sound signals. Instead, stronger responses were found in regions that process sound (the auditory cortex) and emotions (the insula).

At the same time, there was lower activity in brain regions that normally help calm or regulate reactions.

“Their brains are responding differently, in regions that process both the loudness of sound and its emotional impact,” Ashar said.

The research team also looked at treatment options, and found that Pain Reprocessing Therapy was the most effective at managing this sensitivity.

In this therapy, people are taught to reinterpret pain as a problem stemming from the brain rather than just the back. 

Earlier studies have found that this therapy can help as many as two-thirds of people with chronic back pain to become pain-free or nearly so, researchers said.

Results from the new study showed that Pain Reprocessing Therapy not only reduced the brain response to sound, but also increased activity in regions involved in regulating unpleasant experiences, researchers said.

“This shows that the brain’s exaggerated sensory response can improve with psychological treatment so instead of being something patients are stuck with, this sensitivity is treatable,” Ashar said.

“These findings add to growing evidence that chronic back pain is not just a problem in the back,” he said. "The brain plays a central role in driving chronic pain, by amplifying a range of sensations – sensory signals from the back, sounds and likely other sensations as well."

Researchers next plan to test senses other than hearing — such as light, smell or taste — to see if chronic pain causes sensitivity in those as well, and which brain regions are implicated.