Chronic Low Back Pain Management in Primary Care

Phillips, Kelly‐Anne; Chien, Anne; Norwood, Barbara R.; Smith, Chris

doi:10.1097/00006205-200308000-00008

Cited by 7 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 4 , 5 , 6 , 7 , 8 Although these treatments are potentially helpful in acute LBP, there are limited therapies that are efficient in the management of chronic LBP. 9 , 10 , 11 , 12 For example, treatments available to relieve chronic LBP and recurrent onset back pain include an invasive operation to remove the IVD and potentially fuse adjacent vertebrae, which can lead to the alteration of the normal physiological and biomechanical function of the spine. 13 In some cases spinal fusion can increase the risk of adjacent segment disease, where the spinal segment directly below or above the site of the fused IVD experiences increased biomechanical demands, which can lead to accelerated IVD degeneration.…”

Section: Introductionmentioning

confidence: 99%

Cell sources proposed for nucleus pulposus regeneration

et al. 2021

View full text Add to dashboard Cite

Lower back pain (LBP) occurs in 80% of adults in their lifetime; resulting in LBP being one of the biggest causes of disability worldwide. Chronic LBP has been linked to the degeneration of the intervertebral disc (IVD). The current treatments for chronic back pain only provide alleviation of symptoms through pain relief, tissue removal, or spinal fusion; none of which target regenerating the degenerate IVD. As nucleus pulposus (NP) degeneration is thought to represent a key initiation site of IVD degeneration, cell therapy that specifically targets the restoration of the NP has been reviewed here. A literature search to quantitatively assess all cell types used in NP regeneration was undertaken. With key cell sources: NP cells; annulus fibrosus cells; notochordal cells; chondrocytes; bone marrow mesenchymal stromal cells; adiposederived stromal cells; and induced pluripotent stem cells extensively analyzed for their regenerative potential of the NP. This review highlights: accessibility; expansion capability in vitro; cell survival in an IVD environment; regenerative potential; and safety for these key potential cell sources. In conclusion, while several potential cell sources have been proposed, iPSC may provide the most promising regenerative potential.

show abstract

Section: Introductionmentioning

confidence: 99%

Cell sources proposed for nucleus pulposus regeneration

et al. 2021

View full text Add to dashboard Cite

show abstract

“…1,2 Intervertebral disc (IVD) degeneration has a strong association with low back pain. 3 Herniated disc leads to mechanical compression of nerves and a chemical inflammatory cascade that cause neurologic symptoms or radiculopathy. A wide range of pro-inflammatory mediators, including IL-1, TNF-α, IL-6, IL-8, and other chemokines, have been found within degenerated discs.…”

Section: Introductionmentioning

confidence: 99%

Nanoparticle fullerol alleviates radiculopathy via NLRP3 inflammasome and neuropeptides

Jin

Ding

Oklopcic

et al. 2017

Nanomedicine: Nanotechnology, Biology and Medicine

View full text Add to dashboard Cite

The present study aimed to evaluate the analgesic effect of the antioxidant nanoparticle fullerol in a mouse radiculopathy and a dorsal root ganglion (DRG) culture models. Intervertebral disc degeneration causes significant hyperalgesia and nerve inflammation. Pain sensitization and inflammatory reaction were counteracted by fullerol when disc material was bathed in 10 or 100µM of fullerol prior to implantation. Immunohistochemistry showed similar massive IBA1 positive macrophage infiltration surrounding implanted disc material among groups, but IL-1β and IL-6 expression was decreased in fullerol treated group. In the DRG explant culture, after treatment with TNF-α, the expression of IL-1β, NLRP3, and caspase 1 was significantly increased but this was reversed by the addition of fullerol. In addition, fullerol also decreased the expression of substance P and CGRP in the cultured DRGs. Nanoparticle fullerol effectively counteracts pain sensitization and the inflammatory cascade caused by disc degeneration.

show abstract

“…animal model, disc degeneration, discogenic pain, mouse, pain measurement 1 | INTRODUCTION Low back pain (LBP), which affects over 80% of adults during their lives, is one of the most common clinical problems in the world (Balagué, Mannion, Pellisé, & Cedraschi, 2012;Patrick, Emanski, & Knaub, 2016). Currently, LBP is the leading cause of disability globally (Vos et al, 2013), with high medical expenses and decreased productivity, and which puts a great burden on both the individual and society (Phillips, Ch'ien, Norwood, & Smith, 2003). Although any of the lumbar spinal structures could be a source of LBP, the intervertebral disc (IVD) is thought to be the most common detectable cause (Hurri & Karppinen, 2004).…”

mentioning

confidence: 99%

Development of an in vivo mouse model of discogenic low back pain

Shi

Das

et al. 2018

Journal Cellular Physiology

View full text Add to dashboard Cite

Discogenic low back pain (DLBP) is extremely common and costly. Effective treatments are lacking due to DLBP's unknown pathogenesis. Currently, there are no in vivo mouse models of DLBP, which restricts research in this field. The aim of this study was to establish a reliable DLBP model in mouse that captures the pathological changes in the disc and allows longitudinal pain testing. The model was generated by puncturing the mouse lumbar discs (L4/5, L5/6, and L6/S1) and removing the nucleus pulposus using a microscalpel under the microscope. Histology, molecular pathways, and pain-related behaviors were examined. Over 12 weeks post-surgery, animals displayed the mechanical, heat, and cold hyperalgesia along with decreased burrowing and rearing. Histology showed progressive disc degeneration with loss of disc height, nucleus pulposus reduction, proteoglycan depletion, and annular fibrotic disorganization. Immunohistochemistry revealed a substantial increase in inflammatory mediators at 2 and 4 weeks. Nerve growth factor was upregulated from 2 weeks to the end of the experiment. Nerve fiber ingrowth was induced in the injured discs after 4 weeks. Disc-puncture also produced an upregulation of neuropeptides in dorsal root ganglia neurons and an activation of glial cells in the spinal cord dorsal horn. These findings indicate that the cellular and structural changes in discs, as well as peripheral and central nervous system plasticity, paralleled persistent, and robust behavioral pain responses. Therefore, this mouse DLBP model could be used to investigate mechanisms underlying discogenic pain, thereby facilitating effective drug screening and development of treatments for DLBP.

show abstract

Chronic Low Back Pain Management in Primary Care

Cited by 7 publications

References 9 publications

Cell sources proposed for nucleus pulposus regeneration

Cell sources proposed for nucleus pulposus regeneration

Nanoparticle fullerol alleviates radiculopathy via NLRP3 inflammasome and neuropeptides

Development of an in vivo mouse model of discogenic low back pain

Contact Info

Product

Resources

About