Overcoming Pain

Why people experience chronic pain, and the power they have to de-intensify it.

Maybe Not Just Degenerative Disc Disease: The Immune System and Low Back Pain

Back pain moves from the back burner.

Degeneration of the intervertebral disc, often called degenerative disc disease of the spine, is a condition that can be painful and greatly affect the quality of one's life. And while disc degeneration is just one more fact of aging life for quite a few individuals, degenerative disease can be the source of severe and chronic pain.

It is felt that some discs become painful due to inflammation, and when pain from degenerative disc disease is severe, traditional nonoperative treatment is often ineffective.

An article published in this month's issue of "Arthritis and Rheumatism" reveals that the immune system may contribute to causing the low back pain associated with herniated and degenerated discs. Researchers feel they have identified a substance that could trigger the inflammatory process for disc herniation and disc degeneration.

The substance is interleukin-17 (IL-17), and the authors of the article found IL-17 in more than 70% of surgical tissue samples taken from patients with degenerated or herniated disc disease. In contrast, IL-17 was rarely detected in healthy disc tissue samples. Apparently this finding has not been reported previously, and suggests that IL-17 may be a mediator for disc herniation and the inflammatory pain associate with both herniation and disc degeneration.

Of course, low back pain is a frequent cause for visits to the doctor; the economic burden is estimated in the hundreds of billions just in the United States. Degenerative disc problems account for a significant portion of the pain and the health care dollars spent. It is not clear, however, in what way this discovery regarding IL-17 will help to alleviate pain, or the budget deficit. Nevertheless, theoretically speaking, future chronic back pain patients may derive relief from a medication that blocks IL-17. These Il-17 blocking medications are being studied for well-known inflammatory diseases such as rheumatoid arthritis. It remains to be seen whether IL-17 blockade will be a worthwhile therapeutic option for degenerative disc disease patients.

Other illnesses for which IL-17 plays a role in the inflammatory cascade include certain types of psoriasis, gum disease, and the inflammatory bowel disorder, Crohn's disease.

Chronic degenerative disc disease pain has been characterized as the result of aging and wear-and-tear for many years. It is important that researchers continue to search for links to the immune system, as this has the potential of opening up a whole new array of treatments.

 

Chronic back pain does not have to be inevitable.

 

 

 



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Mark Borigini, M.D., is a board-certified rheumatologist who has devoted his career to treating, and training others to treat, a wide variety of illnesses that cause chronic pain and disability.

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