The use of artificial intelligence in treating chronic back pain.

Chronic back pain is a debilitating disorder that is believed to be experienced by close to a quarter of the adult population globally [1]. With the recent advancements in technology, artificial intelligence (AI) has played a crucial role in healthcare, such as safely filtering patient information, analyzing medical imaging, providing recommendations for diagnoses, and even acting as virtual assistants for both physicians and patients [2]. One of the ways AI has been used in pain medicine and in helping patients with low back pain is aiding in the diagnoses of various conditions through interpretations of MRI, CT, X-ray, and other imaging modalities. Previous studies have already assessed the accuracy of artificial intelligence in diagnosing low back pain associated with spinal stenosis, disc degeneration, and lumbar arthritis [3]. One systematic review found that through the use of various machine learning models, physicians can use AI to differentiate patients with and without low back pain through the analysis of brain MRI [3]. AI can be used to filter and interpret clinical data, electromyography studies, and even physical motion to diagnose or predict the onset of various low back pain conditions. Some studies in the systematic review reported an accuracy of up to over 90% [3]. AI can be used to not only interpret these imaging modalities, but it can be used to enhance and even reconstruct an entire imaging of the spine as well. AI algorithms can be trained to differentiate between noisy and clear MRI or CT images, where this training can be applied by having the software reconstruct high-quality images [4]. This will allow the radiologists, interventional pain physicians, and even spine surgeons to have a better understanding of the disease at hand and how to best operate on patients. Past studies have even mentioned the use of AI to create completely new images from given data. For example, with a given MRI image, AI can be used to translate the information into a synthetic CT image, allowing physicians to obtain a more comprehensive view of a patient’s spine or nerves [4]. Even something as mundane as labeling the different parts can be completed by AI to save the physician's time. AI can also be effectively used to identify pain using neurophysiology-based methods [5]. Electroencephalography (EEG), a technique that records the brain’s electrical impulses, has been used to identify and even measure pain intensity [5,6]. A systematic review examined 22