A recent study conducted by researchers at Cedars-Sinai Medical Center may have found the answer to the cause of a specific type of back pain. Degenerating disks in the spine are responsible for nearly 40% of cases of low back pain in adults. Until now, the exact reason why these disks become painful has remained unclear. However, the Cedars-Sinai study, published in the journal Science Translational Medicine, may have uncovered the key cell subtype involved and potentially opened the door to targeted treatment options.
The spine is made up of bones that are cushioned by intervertebral disks filled with jelly-like substance, serving as shock absorbers. These disks can degenerate and dry out due to factors such as age, overuse, or injury. However, not all degenerated disks cause pain. This is because the inner layers of the disks lack nerve endings. However, in some cases, when disks degenerate, nerve endings from surrounding tissues invade the disk, leading to pain.
The study analyzed different cell types in the jelly-like layer of the disks and compared cells from patients with pain-free degenerated disks to those from patients experiencing disk-associated low back pain. The researchers discovered that patients with low back pain had a higher number of a specific subtype of cell that may play a role in the onset of the pain.
This breakthrough in understanding disk-associated back pain could pave the way for nonsurgical biologic treatments, according to Dr. Hyun Bae, a professor of surgery and orthopedics at Cedars-Sinai. It represents a significant step towards revolutionizing orthopedic treatments and offering hope to millions suffering from back pain worldwide, added Dr. Mark Vrahas, chair of Cedars-Sinai Orthopedics.
In further experiments, the researchers subjected healthy cells to conditions that simulated disk degeneration, including inflammation, acidity, tension, compression, low glucose, and low oxygen. They found that these conditions transformed the healthy cells into the pain-associated cell subtype.
The researchers also created a two-chamber laboratory chip, growing cells in one chamber and introducing pain-signaling neurons derived from stem cells in the other chamber. When pain-associated cells were present in the chip, the pain-signaling neurons grew axons towards them. However, when healthy cells were in the chamber, the neurons did not send out axons.
The study’s findings suggest that future treatments could focus on reprogramming pain-associated intervertebral disk cells into healthy cells or introducing healthy cells to disk tissues to suppress the pain-associated cells, explained Dr. Clive Svendsen, executive director of the Board of Governors Regenerative Medicine Institute at Cedars-Sinai.
By targeting the specific cell subtype responsible for pain or supplementing the healthy cell subtype, researchers may develop effective strategies for addressing the root causes of low back pain. This study contributes to the understanding of disk-related pain and could lead to targeted cell therapies, added Dr. Svendsen.
In conclusion, this study represents a significant advancement in identifying the cells involved in disk-related back pain. The findings provide valuable insights that could lead to the development of innovative treatments for millions of individuals suffering from low back pain.