What is Causing Your Lower Back Pain?

February 12, 2024 at 9:09 a.m.

A new study may have cracked the mystery surrounding the cause of a specific type of back pain. Almost 40% of the adult population experiences low back pain due to degenerating disks in the spine, but medical science hasn’t understood exactly why the disks become painful. In a new study published in the journal Science Translational Medicine, Cedars-Sinai investigators point the way to an answer and possibly a step toward targeted treatment.

“We’ve identified for the first-time particular cells that could be the key to understanding disk pain,” said senior study author Dmitriy Sheyn with Cedars-Sinai Medical Center, Los Angeles, California. “Learning more about how these cells work could lead to the eventual discovery of new treatment options.”

The bones making up the spine are interspersed with jelly-filled spacers, known as intervertebral disks, that act as shock absorbers. Due to age, overuse or injury, the jelly starts to dry out and degenerate, but this doesn’t mean that the disk necessarily becomes painful.

“This is because the inner jelly-like layers of the disks contain no nerve endings,” said Sheyn, who is also an assistant professor of Orthopaedics, Surgery, and Biomedical Sciences at Cedars-Sinai. “But sometimes, when disks degenerate, nerve endings from the surrounding tissues invade the disk, and we believe this causes pain.”

Several cell types exist in this jelly-like layer, and when investigators compared cells from patients with pain-free degenerated discs and patients with disk-associated low back pain, they found that patients experiencing low back pain had greater numbers of a certain subtype of cell that might be involved in the onset of the pain.

Future treatments based on this new information might focus on reprogramming pain-associated intervertebral disk cells into healthy cells, or on adding healthy cells to painful disks to overwhelm the pain-associated cells.

Precisely targeting the ‘bad’ cell subtype or supplementing the ‘good’ cell subtype may provide useful strategies for treating disk-based low back pain, according to the researchers. This current study validated some knowledge in classical disk or pain biology and could be a step toward a targeted cell therapy that addresses the root causes of low back pain.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com. 

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