Lower back pain is one of the most common health problems in the world. Nearly everyone will experience it at some point in life.
For some people, the pain lasts only a few days or weeks. For others, it becomes a long-term condition that affects work, sleep, exercise, and everyday activities. As people grow older, the risk of ongoing back pain becomes even higher because the spine naturally changes with age.
Doctors currently treat lower back pain in many ways. Depending on the cause, treatment may include pain-relieving medicines, physical therapy, exercise, injections, or surgery.
While these approaches often reduce symptoms, they do not always fix the underlying problem. Researchers have therefore been searching for new treatments that target the biological changes that cause pain in the first place.
A new study suggests that an experimental approach could one day do exactly that. Scientists have found that a drug called Navitoclax may reduce lower back pain by removing old, damaged cells inside the spine. The research was published as a peer-reviewed preprint in the journal eLife.
The researchers focused on special bone cells called osteoclasts. These cells have an important job. They break down old or damaged bone so that the body can replace it with new, healthy bone. This process is essential for keeping bones strong throughout life.
However, as people age, some osteoclasts stop working properly. These cells enter a state called cellular senescence. Senescent cells are still alive, but they no longer perform their normal jobs.
Instead, they release harmful chemicals that can damage nearby tissues and increase inflammation. Scientists now believe that these aging cells contribute to many diseases linked with growing older.
In this study, the researchers discovered that senescent osteoclasts collect in a part of the spine called the endplate. The endplate is a thin layer of tissue located between the bones of the spine, known as vertebrae, and the spinal discs that act as cushions. Healthy endplates help support the discs and allow nutrients to move through the spine.
When senescent osteoclasts build up, they weaken the endplates and make them more porous. This damage allows new nerves and blood vessels to grow into areas where they normally should not be. The extra nerves can become highly sensitive and send pain signals to the brain, contributing to chronic lower back pain.
To test their idea, the scientists studied mice with age-related spinal degeneration and mice with unstable spines. Both groups showed large numbers of senescent osteoclasts, damaged endplates, and clear signs of pain.
The researchers then treated the mice with Navitoclax. This drug is already being investigated for its ability to remove senescent cells in other diseases. After treatment, the mice had far fewer aging osteoclasts.
Their spinal endplates became stronger, fewer abnormal nerves and blood vessels developed, and the animals showed much less pain. They also moved around more, suggesting they were more comfortable.
These findings are important because the treatment appeared to target one of the underlying causes of pain instead of simply blocking pain signals. By removing harmful aging cells, the drug helped reduce the damage that leads to chronic pain.
Even so, the research is still at an early stage. The experiments were performed in mice, not people. Many treatments that work well in animals do not always produce the same results in human clinical trials.
In addition, Navitoclax can cause side effects and was originally developed for other medical conditions. Researchers will need to determine whether it is safe and effective for treating back pain before it could ever become a routine treatment.
The growing field of senolytic medicine, which aims to remove harmful aging cells from the body, has attracted increasing attention in recent years. Scientists are studying these drugs for conditions ranging from cancer to age-related diseases. This new research suggests that chronic back pain may eventually join that list.
If future human studies confirm these results, doctors may one day have treatments that not only reduce pain but also slow or even reverse some of the age-related changes that damage the spine. Although much more research is needed, the study offers new hope for millions of people living with chronic lower back pain.
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