Moving Forward With Research to Help Back Pain

Back pain is the single leading cause of disability throughout the world—responsible for the suffering of upwards of a half-billion people. The distress it causes is one of the sources of the opioid epidemic in the U.S., and back pain is difficult to treat because its mechanisms are poorly understood.

To Makarand Risbud, PhD, the James J. Maguire, Jr. Professor of Spine Research, this means now is the perfect time for scientific investigation. Because the spine is central to every movement, its cells change infrequently, or not at all, throughout a person’s life. This is to preserve the spine’s structure and prevent any errors from accumulating in the process of transformation.

“Part of what makes the spine so challenging to fix is that it does not heal itself, so we have to find ways of helping it to do that,” he says. Risbud and his team are targeting intervertebral discs, fluid-filled cushions between bones, which are vital to the spine’s ability to absorb force and to move fluidly without injury. Because discs are involved in so many movements, they are prone to injury; everyone knows someone with a “slipped disc.”

Risbud’s lab team has two goals: to “see” back pain by identifying molecular markers present in patients suffering from the affliction and to develop regenerative techniques. In the first case, Risbud’s lab has identified a number of inflammatory molecules that are present in injured tissue and could represent telltale signs of disc degeneration. With the latter objective, the team has identified a small population of stem cells within intervertebral tissue that could be engineered to perform a healing function.

In combining the two approaches, Risbud imagines a future when physicians are empowered to stop disc breakdown, maintain the disc’s structural integrity, and ultimately prevent pain entirely using targeted therapies to ease it at its source.