Spine Research Institute joins national effort to address back pain, opioid abuse

Data from a national health survey indicate that 20 percent of adults in the United States reported “frequent” back pain and 28 percent experienced low back pain that lasted one or more days during the previous three months. Unfortunately, it is common to not know the source of back pain when it occurs and pain relief drugs have become a common practice for treatment.  

The National Institutes of Health (NIH) recently launched the Back Pain Consortium (BACPAC) initiative, a patient-centric translational research program focused on chronic low back pain, a major contributor to the use of opioids in the U.S.

A team of interdisciplinary researchers at The Ohio State University will lead one BACPAC initiative and participate in another. Both efforts will pursue development of an integrated model of back pain and patient-based algorithms to identify treatments tailored to the individual patient.

Through the Helping to End Addiction Long-term (HEAL) Initiative, NIH awarded 13 grants, totaling approximately $150 million, to form the BACPAC Research Program. Ohio State’s Spine Research Institute (SRI) will host one of six BACPAC Technology Research Sites and will collaborate in a BACPAC Mechanistic Research Center led University of California, San Francisco.

Despite increased utilization of interventions and rising medical costs, chronic low back pain prevalence has continued to increase. According to SRI Executive Director and Principal Investigator for these grants Engineering Professor Bill Marras, the increase is due in part to treatments that rely too heavily on subjective measures and fail to target the associated biopsychosocial mechanisms.

“Specifically, most diagnostics do not quantitatively consider patient functional measures,” he said. “We will address this by developing and validating a digital health platform and provide meaningful data-driven metrics that enable an integrated approach to clinical evaluation and treatment.”

SRI’s platform will collect and combine quantitative spinal motion metrics, patient-reported outcomes and patient preference information to help guide optimal personalized treatment plans. By the end of the project, Marras said they should have a validated tool for integration into other consortium-funded research studies.

The University of California, San Francisco-led center will conduct both translational and clinical research to clarify back pain’s biopsychosocial mechanisms—the interconnection between biology, biomechanics, psychology and socio-environmental factors—which will be catalytic for new therapeutic, diagnostic and prevention strategies. SRI’s collaborator role will entail applying the wearable sensors they developed to low back patients at UCSF and comparing their ability to document low back pain with other technologies. These efforts will bring engineering technology together with medical records documentation and machine learning, with the goal of identifying low back pain phenotypes.

“We hope to be able to identify the correct treatment for the type of back pain an individual is suffering from,” said Marras. “Since back pain is a leading cause for prescription opioid use, the expectation is that this work will result in a dramatic decrease in the need to prescribe opioids for back pain.”

Partnering faculty from The Ohio State University Wexner Medical Center include Drs. Ehud Mendel (Neurosurgery), Safdar Khan (Orthpaedic Surgery) and Tristan Weaver (Anesthesiology). Staff from the SRI include Jonathan Dufour and Alex Aurand.