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Low Back Pain

  • Angela R. StarkweatherEmail author
  • Susan G. Dorsey
Chapter
  • 23 Downloads

Abstract

Low back pain is one of the most common musculoskeletal conditions and among the top causes of disability worldwide. Low back pain can be associated with a specific pathology such as spinal stenosis, herniated disc, or spondylolisthesis; however, most cases of low back pain do not have an identifiable mechanical source or structural deformity. Characterizing the location, affective and sensory dimensions, intensity and interference of pain is crucial for precise phenotyping and investigation of underlying mechanisms. The following chapter will review methods of phenotyping low back pain and the integration of multi-omic based measures to study the transition from acute to chronic pain, which is relevant for other types of musculoskeletal pain, and discuss major findings in the field.

Keywords

Axial low back pain Low back pain Musculoskeletal pain 

References

  1. Amaya F, Izumi Y, Matsuda M, Sasaki M. Tissue injury and related mediators of pain exacerbation. Curr Neuropharmacol. 2013;11:592–7.  https://doi.org/10.2174/1570159X11311060003.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Anders S, Huber W. Differential expression analysis for sequence count data. Genome Biol. 2010;11(10):R106.  https://doi.org/10.1186/gb-2010-11-10-r106.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Barbe MF, Barr AE. Inflammation and the pathophysiology of work-related musculoskeletal disorders. Brain Behav Immun. 2006;20:423–9.  https://doi.org/10.1016/j.bbi.2006.03.001.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Barbe MF, Gallagher S, Popoff SN. Serum biomarkers as predictors of stage of work-related musculoskeletal disorders. J Am Acad Orthop Surg. 2013;21:644–6.  https://doi.org/10.5435/JAAOS2110-644.CrossRefPubMedGoogle Scholar
  5. Barr AE, Barbe MF. Inflammation reduces physiological tissue tolerance in the development of work-related musculoskeletal disorders. J Electromyogr Kinesiol. 2004;14:77–85.  https://doi.org/10.1016/j.jelekin.2003.09.008.CrossRefPubMedGoogle Scholar
  6. Binch AL, Cole AA, Breakwell LM, Michael AL, Chiverton N, Cross AK, Le Maitre CL. Expression and regulation of neurotrophic and angiogenic factors during human intervertebral disc degeneration. Arthritis Res Ther. 2014;16(5):416.CrossRefGoogle Scholar
  7. Bove GM, Weissner W, Barbe MF. Long lasting recruitment of immune cells and altered epi-perineurial thickness in focal nerve inflammation induced by complete Freund’s adjuvant. J Neuroimmunol. 2009;213:26–30.  https://doi.org/10.1016/j.jneuroim.2009.06.005.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Čeko M, Shir Y, Ouellet JA, Ware MA, Stone LS, Seminowicz DA. Partial recovery of abnormal insula and dorsolateral prefrontal connectivity to cognitive networks in chronic low back pain after treatment. Hum Brain Mapp. 2015;36:2075–92.  https://doi.org/10.1002/hbm.22757.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Cinar-Medeni O, Elbasan B, Duzgun I. Low back pain prevalence in healthcare professionals and identification of factors affecting low back pain. J Back Musculoskelet Rehabil. 2017;30(3):451–9.  https://doi.org/10.3233/BMR-160571.CrossRefPubMedGoogle Scholar
  10. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, Carrino J, Chou R, Cook K, DeLitto A, Goertz C, Khalsa P, Loeser J, Mackey S, Panagis J, Rainville J, Tosteson T, Turk D, Von Korff M, Weiner DK. Report of the NIH task force on research standards for chronic low back pain. Pain Med. 2014;15(8):1249–67.  https://doi.org/10.1111/pme.12538.CrossRefPubMedGoogle Scholar
  11. Dorsey SG, Renn CL, Griffioen M, Lassiter CB, Zhu S, Huot-Creasy H, McCracken C, Mahurkar A, Shetty AC, Jackson-Cook CK, Kim H, Henderson WA, Saligan L, Gilll J, Colloca L, Lyon DE, Starkweather AR. Whole blood transcriptomic profiles can differentiate vulnerability to chronic low back pain. PLoS One. 2019;14(5):e0216539.  https://doi.org/10.1371/journal.pone.0216539.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Dutmer AL, Reneman MF, Schiphorst Preuper HR, Wolff AP, Speijer BL, Soer R. The NIH minimal dataset for chronic low back pain: responsiveness and minimal clinically important change. Spine. 2019;44(20):E1211.  https://doi.org/10.1097/BRS.0000000000003107.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Elliott MB, Barr AE, Clark BD, Amin M, Amin S, Barbe MF. High force reaching task induces widespread inflammation, increased spinal cord neurochemicals and neuropathic pain. Neuroscience. 2009;158:922–31.  https://doi.org/10.1016/j.neuroscience.2008.10.050.CrossRefPubMedGoogle Scholar
  14. Fisher PW, Zhao Y, Rico MC, et al. Increased CCN2, substance P and tissue fibrosis are associated with sensorimotor declines in a rat model of repetitive overuse injury. J Cell Commun Signal. 2015;9:37–54.  https://doi.org/10.1007/s12079-015-0263-0.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Fong G, Backman LJ, Hart DA, Danielson P, McCormack B, Scott A. Substance P enhances collagen remodeling and MMP-3 expression by human tenocytes. J Orthop Res. 2013;31:91–8.  https://doi.org/10.1002/jor.22191.CrossRefPubMedGoogle Scholar
  16. Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG, Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges and promising directions. Lancet. 2018;391:2368–83.  https://doi.org/10.1016/S0140-6736(18)30489-6.CrossRefPubMedGoogle Scholar
  17. Freidin MB, Keser T, Gudelj I, Stambuk J, Vucenovic D, Allegri M, Pavic T, Simurina M, Fabiane SM, Lauc G, Williams FMK. The association between low back pain and composition of IgG glycome. Sci Rep. 2016;6:26815.CrossRefGoogle Scholar
  18. Guo T-M, Liu M, Zhang Y-G, Guo W-T, Wu S-X. Association between Caspase-9 promoter region polymorphisms and discogenic low back pain. Connect Tissue Res. 2011;52(2):133–8.CrossRefGoogle Scholar
  19. Hansen BB, Hansen P, Carrino JA, Fournier G, Rasti Z, Boesen M. Imaging in mechanical back pain: anything new? Best Pract Res Clin Rheumatol. 2016;30(40):766–85.CrossRefGoogle Scholar
  20. Hasvik E, Schistad EI, Grvle G, Haugen AJ, Re C, Gjerstad J. Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex-OPRM1 A118G polymorphism interaction: a prospective 1-year observational study. BMC Musculoskelet Disord. 2013;15(1):161–7.CrossRefGoogle Scholar
  21. Henderson LA, Keay KA. Imaging acute and chronic pain in the human brainstem and spinal cord. Neuroscientist. 2018;24(1):84–96.  https://doi.org/10.1177/1073858417703911.CrossRefPubMedGoogle Scholar
  22. Hides JA, Donelson R, Lee D, Prather H, Sahrmann SA, Hodges PW. Convergence and divergence of exercise-based approaches that incorporate motor control for the management of low back pain. J Orthop Sports Phys Ther. 2019;49(6):437–52.  https://doi.org/10.2519/jospt.2019.8451.CrossRefPubMedGoogle Scholar
  23. Hodges PW, Barbe MF, Loggia ML, Nijs J, Stone LS. Diverse role of biological plasticity in low back pain and its impact on sensorimotor control of the spine. J Orthop Sports Phys Ther. 2019;49(6):389–401.  https://doi.org/10.2519/jospt.2019.8716.CrossRefPubMedGoogle Scholar
  24. Horton R, Wilming L, Rand V, et al. Gene map of the extended human MHC. Nat Rev Genet. 2004;5(12):889–99.  https://doi.org/10.1038/nrg1489.CrossRefPubMedGoogle Scholar
  25. Jacobsen L, Schistad E, Storesund A, Pedersen L, Rygh L, Re C, Gjerstad J. The COMT rs4680 met allele contributes to long-lasting low back pain, sciatica and disability after lumbar disc herniation. Eur J Pain. 2012;16(7):1064–9.CrossRefGoogle Scholar
  26. Jacobsen LM, Schistad EI, Storesund A, Pedersen LM, Espeland A, Rygh LJ, Re C, Gjerstad J. The MMP1 rs1799750 2G allele is associated with increased low back pain, sciatica, and disability after lumbar disk herniation. Clin J Pain. 2013;29(11):967–71.CrossRefGoogle Scholar
  27. James G, Sluka KA, Blomster L, et al. Macrophage polarization contributes to local inflammation and structural change in the multifidus muscle after intervertebral disc injury. Eur Spine J. 2018a;27:1744–56.  https://doi.org/10.1007/s00586-018-5652-7.CrossRefPubMedGoogle Scholar
  28. James G, Millecamps M, Stone LS, Hodges PW. Dysregulation of the inflammatory mediators in the multifidus muscle after spontaneous intervertebral disc degeneration [in] SPARC-null mice is ameliorated by physical activity. Spine. 2018b;43:E1184–94.  https://doi.org/10.1097/BRS.0000000000002656.CrossRefPubMedGoogle Scholar
  29. James G, Klyne DM, Millecamps M, Stone LS, Hodges PW. ISSLS Prize in basic science 2019: physical activity attenuates fibrotic alterations to the multifidus muscle associated with intervertebral disc degeneration. Eur Spine J. 2019;28(5):893–904.  https://doi.org/10.1007/s00586-019-05902-9.CrossRefPubMedGoogle Scholar
  30. Ji RR, Chamessian A, Zhang YQ. Pain regulation by non-neuronal cells and inflammation. Science. 2016;354:572–7.  https://doi.org/10.1126/science.aaf8924.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Laskin DL. Macrophages and inflammatory mediators in chemical toxicity: a battle of forces. Chem Res Toxicol. 2009;22:1376–85.  https://doi.org/10.1021/tx900086v.CrossRefPubMedPubMedCentralGoogle Scholar
  32. Livshits G, Popham M, Malkin I, Sambrook PN, Macgregor AJ, Spector T, Williams FM. Lumbar disc degeneration and genetic factors are the main risk factors for low back pain in women: the UK twin spine study. Ann Rheum Dis. 2011;70:1740–5.  https://doi.org/10.1136/ard.2010.137836.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Loncar Z, Curic G, Havelka Mestrovic A, Mickovic V, Bilic M. Do IL-1B and IL-1RN modulate chronic low back pain in patients with post-traumatic post-traumatic stress disorder? Coll Antropol. 2013;37(4):1237–44.PubMedGoogle Scholar
  34. MacGregor AJ, Andrew T, Sambrook PN, Spector TD. Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Rheum. 2004;51:160–7.  https://doi.org/10.1002/art.20236.CrossRefPubMedGoogle Scholar
  35. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389:736747.CrossRefGoogle Scholar
  36. Malfliet A, Kregel J, Coppieters I, De Pauw R, Meeus M, Roussel N, Cagnie B, Danneels L, Nijs J. Effect of pain neuroscience education combined with cognition targeted motor control training on chronic spinal pain: a randomized clinical trial. JAMA Neurol. 2018;75:808–17.  https://doi.org/10.1001/jamaneurol.2018.0492.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Manek NJ, MacGregor AJ. Epidemiology of back disorders: prevalence, risk factors, and prognosis. Curr Opin Rheumatol. 2005;17(2):134–40.  https://doi.org/10.1097/01.bor.0000154215.08986.06.CrossRefPubMedGoogle Scholar
  38. Menz HB, Dufour AB, Riskowski JL, Hillstrom HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham study. Rheumatology. 2013;52(12):2275–82.  https://doi.org/10.1093/rheumatology/ket298.CrossRefPubMedGoogle Scholar
  39. Mills EP, Di Pietro F, Alshelh Z, Peck CC, Murray GM, Vickers ER, Henderson LA. Brainstem pain-control circuitry connectivity in chronic neuropathic pain. J Neurosci. 2018;38(2):465–573.  https://doi.org/10.1523/JNEUROSCI.1647-17.2017.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Mu J, Ge W, Zuo X, Chen Y, Huang C. Analysis of association between IL-1b, CASP-9, and GDF5 variants and low-back pain in Chinese male soldiers: clinical article. J Neurosurg Spine. 2013;19(2):243–7.CrossRefGoogle Scholar
  41. Omair A, Lie BA, Reikeras O, Holden M, Brox JI. Genetic contribution of catechol-O-methyltransferase variants in treatment outcome of low back pain: a prospective genetic association study. BMC Musculoskeletal Dis. 2012;13(1):76–85.CrossRefGoogle Scholar
  42. Omair A, Holden M, Lie BA, Reikeras O, Brox JI. Treatment outcome of chronic low back pain and radiographic lumbar disc degeneration are associated with inflammatory and matrix degrading gene variants: a prospective genetic association study. BMC Musculoskelet Disord. 2013;14(1):105–14.CrossRefGoogle Scholar
  43. Omair A, Mannion AF, Holden M, Fairbank J, Lie BA, Hagg O, Fritzell P, Brox JI. Catechol-O-methyltransferase (COMT) gene polymorphisms are associated with baseline disability but not long-term treatment outcome in patients with chronic low back pain. Eur Spine J. 2015;24:2425–31.CrossRefGoogle Scholar
  44. Ossipov MH, Morimura K, Porreca F. Descending pain modulation and chronification of pain. Curr Opin Support Palliat Care. 2014;8(2):143–51.  https://doi.org/10.1097/SPC.0000000000000055.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Parisien M, Khoury S, Chabot-Doré A-J, et al. Effect of human genetic variability on gene expression in dorsal root ganglia and association with pain phenotypes. Cell Rep. 2017;19(9):1940–52.  https://doi.org/10.1016/j.celrep.2017.05.018.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Pavan PG, Stecco A, Stern R, Stecco C. Painful connections: densification versus fibrosis of fascia. Curr Pain Headache Rep. 2014;18:441.  https://doi.org/10.1007/s11916-014-0441-4.CrossRefPubMedGoogle Scholar
  47. Pongs O. Voltage-gated potassium channels: from hyperexcitability to excitement. FEBS Lett. 1999;452:31–5.  https://doi.org/10.1016/S0014-5793(99)00535-9.CrossRefPubMedGoogle Scholar
  48. Roh HL, Lee JS, Suh KT, Kim JI, Lee HS, Goh TS, Park SH. Association between estrogen receptor gene polymorphism and back pain intensity in female patients with degenerative lumbar spondylolisthesis. J Spinal Disord Tech. 2013;26(2):E53–7.CrossRefGoogle Scholar
  49. Rut M, Machoy Mokrzynska A, Rezcawowicz D, Soniewski P, Kurzawski M, Drozdzik M, Safranow K, Morawska M, Biaecka M. Influence of variation in the catechol-O-methyltransferase gene on the clinical outcome after lumbar spine surgery for one-level symptomatic disc disease: a report on 176 cases. Acta Neurochir. 2014;156(2):245–52.CrossRefGoogle Scholar
  50. Schistad EI, Jacobsen LM, Re C, Gjerstad J. The interleukin-1a gene C T polymorphism rs1800587 is associated with increased pain intensity and decreased pressure pain thresholds in patients with lumbar radicular pain. Clin J Pain. 2014;30(10):869–74.CrossRefGoogle Scholar
  51. Seminowicz DA, Laferriere AL, Millecamps M, Yu JS, Coderre TJ, Bushnell MC. MRI structural brain changes associated with sensory and emotional function in a rat model of long-term neuropathic pain. NeuroImage. 2009;47:1007–14.  https://doi.org/10.1016/j.neuroimage.2009.05.068.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Seminowicz DA, Wideman TH, Naso L, Hatami-Khouroushahi Z, Fallatah S, Ware MA, Jarzem P, Bushnell MC, Shir Y, Ouellet JA, Stone LS. Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function. J Neurosci. 2011;31:7540–50.  https://doi.org/10.1523/JNEUROSCI.5280-10.2011.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Skouen J, Smith A, Warrington N, O’Sullivan P, McKenzie L, Pennell C, Straker L. Genetic variation in the beta-2 adrenergic receptor is associated with chronic musculoskeletal complaints in adolescents. Eur J Pain. 2012;16(9):1232–42.CrossRefGoogle Scholar
  54. Smart KM, Blake C, Staines A, Doody C. Clinical indicators of ‘nociceptive’, ‘peripheral neuropathic’ and ‘central’ mechanisms of musculoskeletal pain. A Delphi survey of expert clinicians. Man Ther. 2010;15(1):80–7.  https://doi.org/10.1016/j.math.2009.07.005.CrossRefPubMedGoogle Scholar
  55. Solovieva S, Leino-Arjas P, Saarela J, Luoma K, Raininko R, Riihimaki H. Possible association of interleukin 1 gene locus polymorphisms with low back pain. Pain. 2004;109(1):8–19.CrossRefGoogle Scholar
  56. Song Y-Q, Ho DW, Karppinen J, Kao PY, Fan B-J, Luk KD, Yip S-P, Leong JC, Cheah KS, Sham P, et al. Association between promoter-1607 polymorphism of MMP1 and lumbar disc disease in southern Chinese. BMC Med Genet. 2008;9(1):38–44.CrossRefGoogle Scholar
  57. Song YQ, Karasugi T, Cheung KM, Chiba K, Ho DW, Miyake A, et al. Lumbar disc degeneration is linked to a carbohydrate sulfotransferase 3 variant. J Clin Investig. 2013;123(11):4909–17.CrossRefGoogle Scholar
  58. Starkweather AR, Heineman A, Storey S, Rubia G, Lyon D, Greenspan J, Dorsey SG. Methods to measure peripheral and central sensitization using quantitative sensory testing: a focus on individuals with low back pain. Appl Nurs Res. 2016a;29:237–41. PMID: 26856520.CrossRefGoogle Scholar
  59. Starkweather AR, Ramesh D, Lyon DE, Siangphoe U, Deng X, Sturgill J, Heineman A, Elswick RK Jr, Dorsey SG. Acute low back pain: differential somatosensory function and gene expression compared with healthy no-pain controls. Clin J Pain. 2016b;32(11):933–9.  https://doi.org/10.1097/AJP.0000000000000347.CrossRefPubMedPubMedCentralGoogle Scholar
  60. Starkweather A, Julian T, Ramesh D, Heineman A, Sturgill J, Dorsey S, Lyon DE, Wijesinghe DS. Circulating lipids and acute pain sensitization: an exploratory analysis. Nurs Res. 2017;66(6):454–61. PMID: 29095376.CrossRefGoogle Scholar
  61. Tajerian M, Alvarado S, Millecamps M, Dashwood T, Anderson KM, Haglund L, Ouellet J, Szyf M, Stone LS. DNA methylation of SPARC and chronic low back pain. Mol Pain. 2011;7:65.CrossRefGoogle Scholar
  62. Tegeder I, Lötsch J. Current evidence for a modulation of low back pain by human genetic variants. J Cell Mol Med. 2009;13(8b):1605–19.  https://doi.org/10.1111/j.1582-4934.2009.00703.x.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Tegeder I, Costigan M, Griffin RS, Abele A, Belfer I, Schmidt H, Ehnert C, Nejim J, Marian C, Scholz J, et al. GTP cyclohydrolase and tetrahydrobiopterin regulate pain sensitivity and persistence. Nat Med. 2006;12(11):1269–77.CrossRefGoogle Scholar
  64. Trapnell C, Pachter L, Salzberg SL. TopHat: discovering splice junctions with RNA-Seq. Bioinformatics. 2009;25(9):1105–11.  https://doi.org/10.1093/bioinformatics/btp120.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Van Dillen LR, Norton BJ, Sahrmann SA, Evanoff BA, Harris-Hayes M, Holtzman GW, Early J, Chou I, Strube MJ. Efficacy of classification-specific treatment and adherence on outcomes in people with chronic low back pain. A one-year follow-up, prospective, randomized, controlled clinical trial. Man Ther. 2016;24(1):52–64.  https://doi.org/10.1016/j.math.2016.04.003.CrossRefPubMedPubMedCentralGoogle Scholar
  66. Williams FM, Bansal AT, van Meurs JB, Bell JT, Meulenbelt I, Suri P, Rivadeneira F, Sambrook PN, Hofman A, Bierma-Zeinstra S, Menni C, Kloppenburg M, Slagboom PE, Hunter DJ, Macgregor AJ, Uitterlinden AG, Spector TD. Novel genetic variants associated with lumbar disc degeneration in northern Europeans: a meta-analysis of 4600 subjects. Ann Rheum Dis. 2012;72(7):1141–8.  https://doi.org/10.1136/annrheumdis-2012-201551.CrossRefPubMedPubMedCentralGoogle Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of Connecticut School of NursingStorrsUSA
  2. 2.Department of Pain and Translational Symptom ScienceUniversity of Maryland School of NursingBaltimoreUSA

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