BYU one of 10 major universities tasked by NIH to find innovative back pain solutions as part of $150 million BACPAC research program
Students work on the SPINE Sense System, a device which is used to research the causes of back pain.
Photo by Joey Garrison/BYU Photo
A major contributor to opioid addiction is severe back pain, and statistics from the National Institutes of Health show 80% of Americans experience back pain — 20% of whom endure chronic back pain.
To find effective therapies for chronic low back pain, and to help curb opioid addiction, the NIH created the Back Pain Consortium Research Program. BYU is one of 10 major universities (along with Harvard, Ohio State and the University of Utah) tapped to help with this $150 million effort, and new work from researchers here has led to a system to prescribe patient-specific back pain remedies like doctors would prescribe medication.
“Pain is a part of this mortal experience,” said BYU professor Anton Bowden. “It colors what we see and how we experience life, and this project can have a major impact on that.”
Because lower back pain has many causes, and the most effective treatments are dependent on many factors, each patient needs individualized treatment plans. Traditional methods of diagnosing a patient’s condition don’t reveal which treatment approach is best, and for many people with chronic back pain, it takes a lot of trial and error to find solutions.
BYU, along with other key institutions in the program, is running clinical trials to find similarities between people for whom the same treatment is the most effective. Researchers are focused on four treatments:
Photo by Joey Garrison/BYU Photo
the medication Duloxetine
physical therapy
cognitive behavioral therapy
enhanced self-care
In conjunction with the clinical trials, a multidisciplinary group of BYU researchers and students is working to identify optimal treatment plans that can be shared among clinics and physical therapists, eliminating the current trial and error patients must go through.
To develop their analysis and diagnosis process, the team is collecting data on both biopsychosocial well-being and spinal motion. (Biopsychosocial well-being influences many parts of a person’s life, including how their body functions, and can have a large impact on lower back pain.) Patients self-report how they feel psychologically, socially and physiologically.
Spinal motion is measured by the SPINE Sense System, an array of sensors designed by the BYU Applied Biomechanics Engineering Lab that can measure the speed and range of spinal movement. These sensors are used to measure movement and collect data before, during and after treatment. The motion data collected via the SPINE Sense System is analyzed using an unsupervised machine learning algorithm to group together patients who demonstrate similar phenotypes (i.e., similar motion patterns and demographics).
Preliminary results have been very promising and show that spinal motion phenotypes correlate with biopsychosocial well-being: patients in certain phenotypes experience much more severe pain than others. These findings support the practice of motion-based diagnostics, as well as the theory that patients who exhibit similar phenotypes will respond in like manner to similar treatments. Ongoing research by the BYU team and others is dedicated to identifying the optimal treatments for patients with chronic low back pain according to their individual needs.
“Chronic back pain affects such a large number of people, and this system will be able to help so many of them,” said Spencer Baker, a Ph.D. student working on the project. “People who have been living in daily pain for years can finally have some relief.”
For a project this large, many departments, professors and students are collaborating for a comprehensive and accurate result. Between mechanical engineering, manufacturing engineering, exercise science, computer science and statistics, there are over 40 undergraduate students, approximately 10 graduate students and one postdoctoral student helping with this research.
By January 2024, they expect to have usable data from 300 people who have worn this sensor and participated in the study and from another 200 who have been a part of a clinical trial in 12 different locations. The group will be even closer to pinpointing causes of back pain and helping prescribe patients with treatments that will help.
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The Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, is an aggressive, trans-NIH effort to speed scientific solutions to stem the national opioid public health crisis. Launched in April 2018, the initiative is focused on improving prevention and treatment strategies for opioid misuse and addiction and enhancing pain management. For more information, visit: https://heal.nih.gov
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