Back and neck pain is the most commonly reported pain there is. Alexis Tingan, MD, CAQSM, a physician at Penn Medicine, explained:
Aches and pains in the spine are just facts of life. Moreover, they are incredibly common—some estimates say that upwards of 85% of people will experience some sort of back or neck pain.
In the United States alone, 25% of the adult population has reported lower back pain in the previous three months of any given date. Overall, the condition affects over 15 million adults, racking up billions in lost workdays and healthcare costs.
The list of possible causes includes spinal disease, cancer, an accidental injury, smoking, poor eating habits, being overweight, and aging – the number one cause. While most health conditions and accidents are unavoidable, lifestyle choices are, but we’ll get into that later. Aging, of course, is among the inevitable culprits. Fortunately, scientists experimenting with anti-aging drugs have identified a potential treatment for age-related back pain using senolytic drugs.
Aging contributes to spinal pain because the discs that cushion and support vertebrae begin to degenerate. Vertebrae are the individual bones of the spine. They are stacked on top of one another with joints and disks containing jelly-like centers in between, which act as shock absorbers and prevent the vertebrae from rubbing against each other. These disks shrink and wear away as we age, causing stiffness and pain as the bones start to rub against one another. Unfortunately, few treatments are available, albeit this is a widespread condition.
Current treatment options include surgery, steroid injections, and opioid-based painkillers. The first two choices aren’t suitable for everyone and can have limited effectiveness, while the drugs are effective but potent and carry the risk of addiction (especially with prolonged use).
Therefore, a group of scientists from the University of North Carolina in Chapel Hill led by Makarand Risbud, Ph.D. from Thomas Jefferson University, began looking for another effective and non-invasive way to treat back pain from disc degeneration. They turned to senolytics – a small class of molecules used to target cells in the body in senescence (a process of age-related deterioration).
Every tissue in the human body accumulates senescent cells as we age. The older we get, the higher the accumulation of senescent cells, which can’t divide and only accelerate the aging process. The team investigated this process in spinal discs and the effects of senolytic drugs on these destructive cells in the discs.
Their experiments on mice revealed that the senolytic drugs (they used a combination of dasatinib and quercetin) successfully removed the cells, preventing age-related disc degeneration. Their findings could lead to better treatment for chronic back pain.
Risbud said:
Once intervertebral discs start to degenerate, there is very little regeneration that happens. But our results show that it is possible to mitigate the disc degeneration that happens with aging.
Senescent cells are harmful because they secrete destructive enzymes and inflammatory proteins that affect neighboring tissues. When the senolytic drugs remove these cells, they leave room for new cells to replace them and improve the tissue’s function. For example, previous research found the drugs can treat scarring in lung tissue and rejuvenate old cells to make them behave like young cells again. But every tissue is different, so it was exhilarating to find the drugs can work on spinal cells too.
The team gave young and middle-aged mice the drug cocktail via injection once a week in the experiment. The outcome was unexpected. The younger mice had more benefit even though the older animals had accumulated more senescent cells. Moreover, the young mice had shown fewer cells and less disc degeneration by the time they reached old age than the placebo group. Therefore, the treatment works best as a protective measure, not a cure.
Dr. Risbud said:
We anticipated that in tissues with a lot of senescence, removing the senescent cells would make a big difference, but it didn’t. The therapy was most effective when we started treating the mice when those senescent cells were just beginning to emerge. Our findings show that if given early, senolytic drugs can actually slow disc degeneration. This is a novel preventive approach.
The only downside of this is that the animals require weekly injections. However, the long-term treatment showed no adverse effects. Meaning, the study still lays a hopeful foundation for further investigations.
Dr. Risbud said:
It is possible that people will have to take this for a long time for treatment to be effective, and our data show that the drugs were well-tolerated, at least in mice. [Therefore], This research paves the way for translating these studies first to a preclinical animal model and then to a clinical trial in humans.
While their research continues, there are other ways to prevent spinal pain. The condition doesn’t have to be an inevitable part of aging with the right lifestyle approach! As Robin Lustig, DC, a chiropractor at Lustig Healing Arts in Lodi, New Jersey, said:
People with healthy habits can age better.
And that includes staving off back pain. A few essential practices include:
- Maintaining good posture when sitting and standing.
- Keep your weight at a healthy level.
- Eating a healthy, anti-inflammatory diet.
- Exercise to keep your back and abdomen strong.
- Stretching to keep your back and abdomen flexible.
- Sleeping enough every day.
- Take precautions to reduce stress on your back.
You may be wondering, ‘How do my food choices affect my spine?’ and ‘What is an anti-inflammatory diet?’. Well, according to a study published in February 2021, there’s a strong link between what you eat and your chances of having lower back pain. From a cohort of over 3,000 participants, a quarter of them who had the most inflammatory diet had a 42% higher chance of having lower back pain than those with the least pro-inflammatory diet.
Ryanne Lachman, RDN, a registered dietitian at the Cleaveland Clinic’s Center for Functional Medicine in Ohio, explained:
A 42% higher chance of having low back pain with a PRO-INFLAMMATORY DIET is absolutely significant and worth paying attention to. The DII measurement tool and the inflammatory biomarkers the researchers used are both reliable sources of information. The researchers controlled for physical activity, body mass index (BMI), and education, which adds some weight to their findings. Low back pain can be associated with a higher BMI, and so it’s meaningful that the improvements weren’t just because some people on a LOW-INFLAMMATORY DIET weighed less.
The standard American diet involves many pro-inflammatory foods (increase inflammation). People on it consume mostly refined grains that create blood sugar problems and weight gain, as well as trans fats, meat from grain-fed animals, sodas, and fruit juices.
Lachman continued:
One source of inflammation that I think a lot of people don’t realize are refined vegetable oils such as soybean oil, vegetable oil, and corn oil. They’ve all gone through a high level of processing, and they contain omega-6 fats, which are inherently pro-inflammatory. These oils are used in cooking and are often used in baked goods such as cookies or cupcakes. Some of these things aren’t outright harmful in small doses, but when we have them embedded in every product, every processed food, and every restaurant uses them, that’s when chronic inflammation can ensue — from chronic exposure.
Although diet may help improve pain, people shouldn’t think that food has the immediate effect that pain medications may provide. If you change your diet and don’t feel different in the short term, don’t get discouraged. Following an anti-inflammatory diet isn’t just about eliminating foods that cause inflammation. We also need to eat enough of the kinds of foods that will reduce the triggers for inflammation.
So, what are ‘the right foods?’ Colorful fruits and vegetables! Eat 4-6 cups of them (without adding sugar or too much salt) daily to get all the anti-inflammatory nutrients you need, along with loads of other benefits. Have the majority of the 4-6 cups be vegetables, specifically cruciferous ones like broccoli, watercress, and arugula.
Also, consume more omega-3s to help offset omega-6s. A 2018 study found that increasing omega-3 consumption and reducing omega-6 consumption decreases the inflammatory response of a high-fat meal.
Lachman said:
I suggest steering clear of refined oils altogether, but increasing omega-3s can help provide a more anti-inflammatory balance of those oils. My suggestions for upping omega-3 intake would include cold-water fish like salmon, sardines, and cod. Plant-based options can include hemp, flax, or chia seeds.
Also, prepare meals with anti-inflammatory spices such as turmeric, ginger, cayenne, and cinnamon.
Lastly, the method of food preparation is essential as well. Depending on the way you cook your meals, it can worsen inflammation. A 2017 meta-analysis found that frying, microwaving, roasting, searing, or grilling meats, eggs, and fish, produce compounds called advanced glycation end products (AGEs). High-temperature cooking forms new AGEs, a naturally occurring compound in the body and raw animal products. If AGE levels become too high in tissues and blood, it can trigger an inflammatory response.
Therefore, strive to prepare meat dishes by simmering, steaming, or braising and eliminate processed food from your diet as they’ve often been exposed to a high cooking temperature.
Eating a healthy diet will also help you maintain a healthy weight, preventing and reducing back pain. Regular aerobic activity is highly recommended in addition to adopting good eating habits.
Dr. Tingan said:
Every pound on your body puts pressure on your musculoskeletal system. In general, each pound puts about 4 pounds of pressure on the system when walking and 8 pounds when you’re running. The less pressure you can put on your back, the better, so it’s incredibly important to maintain a healthy weight. Exercise helps you lose weight and strengthen your back.
Other things to consider are choosing the proper footwear and taking breaks from sitting or standing by frequently changing position and moving around from time to time.
However, if you experience back pain, it’s not always aging-related and could be a sign of a serious but treatable disease, like cancer. So, get it checked by a doctor just to be safe.
