Low back pain: a major global challenge

Advancing cell therapies for intervertebral disc regeneration from the lab to the clinic: Recommendations of the ORS spine section

“…While current imaging techniques can provide exquisite anatomic detail, standard MRI sequences do poorly at identifying specific pain generators . Recently, a group of international experts concluded that there is no accepted clinical standard for discogenic pain . Equally important, treatment outcomes are currently judged by subjective and qualitative patient reports, which can be influenced by significant placebo effects .…”

“…40 Currently, patient selection for intradiscal therapies includes chronic back pain (>4 VAS) and disability (>40 ODI) that is refractory to conservative care (longer than 6 months 41 Recently, a group of international experts concluded that there is no accepted clinical standard for discogenic pain. 18,19,42,43 Equally important, treatment outcomes are currently judged by subjective and qualitative patient reports, which can be influenced by significant placebo effects. 44 Therefore, to support clinical application and evaluation of intradiscal cellular therapies, there is a critical need for new techniques that localize pain generators and quantify therapeutic effects on treated levels.…”

Pre-surgery physiotherapy and pain thresholds in patients with degenerative lumbar spine disorders

“…Years lived with disability for LBP has increased by 50% since 1990, and is expected to increase as a consequence of an aging and increasing population (2). Lifetime prevalence is now as high as 84% (3) and the condition is common in all age groups and on all continents.…”

Inflammaging determines health and disease in lumbar discs—evidence from differing proteomic signatures of healthy, aging, and degenerating discs

“…The social and economic impact of low back pain is immense and demands an urgent development of novel and effective therapeutic strategies [1]. Attempts to develop effective interventions have been thwarted by several difficulties [2]. Although mechanical loading, trauma, genetics, smoking, and even subclinical infection have been implicated, there is ambiguity in many studies with no clear definition of the initiating or aggravating factors [3−6].…”