Bone hormone could potentially alleviate chronic spinal back pain, study reveals

Potential New Treatment for Chronic Back Pain

A hormone commonly used for treating bone loss might offer a solution to chronic back pain, as suggested by new research findings.

Chronic low back pain is frequently linked to the deterioration of intervertebral discs and vertebral endplates. When these structures fail, they can become porous, allowing previously unaffected nerves to penetrate into the spinal cord, which often leads to pain.

Dr. Janet L. Crane from Johns Hopkins University led a study showing that parathyroid hormone (PTH) could prevent and even reverse the growth of pain-sensing nerves in damaged areas of the spine. PTH, produced naturally by the parathyroid glands, is crucial for regulating calcium and aiding bone remodeling.

Researchers believe these insights could change how back pain is treated, shifting the focus from merely managing symptoms to addressing root causes. Dr. Crane pointed out that during spinal degeneration, nerve growth into atypical areas can occur, but PTH might activate natural signals that push these nerves away.

It’s worth noting that a synthetic version of PTH is already used to treat osteoporosis. Past studies hinted that such treatments might alleviate bone-related pain, but the exact biological mechanisms were unclear.

In their study using animal models, the researchers found that PTH treatment over one to two months led to denser and more stable vertebral endplates. More crucially, this treatment prompted osteoblasts—bone-forming cells—to produce a protein named Slit3. Remarkably, this protein appears to repel growing nerve fibers, preventing them from invading sensitive regions of the spine. When Slit3 was removed in mice, the pain-relieving effects of PTH vanished, underscoring the protein’s significance.

PTH has already gained FDA approval for treating osteoporosis, and some patients taking it for increased bone density have reported unexpected relief from back pain. This research may clarify why that happens.

Dr. Crane remarked that their findings suggest PTH treatment could reduce unusual nerve growth during spinal degeneration. He indicated that this study lays groundwork for future clinical trials aimed at evaluating PTH’s potential as both a disease-modifying and pain-relief treatment for spinal issues.

However, the researchers cautioned that there could be limitations to their findings, including the potential effects of PTH on the central nervous system that weren’t thoroughly examined. Additionally, further studies are needed to explore how other genetic factors and bone formation processes might affect spinal nerve growth and pain relief.