Chronic low back pain is characterised by a range of structural, functional and neurochemical changes within the brain. Significant changes in the neurochemical profile (some markers increase, others decrease) and areas of reduced grey matter volume (or less neuron-matter) have been observed in individuals with chronic low back pain compared to healthy controls. In addition, functional changes in individuals with chronic low back pain are reflected in a cortical reorganisation, altered cortical activity and altered cortical responsiveness. These central changes are seen as a promising target for treatment as most existing approaches to the management of chronic low back pain have only limited success.