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Principal Investigator: Bahar Shahidi
Organization: UNIVERSITY OF CALIFORNIA, SAN DIEGO
Fiscal Year: 2024
Award: $383,229
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Low back pain (LBP) is a complex condition that affects 65-85% of the population, and is the leading
musculoskeletal condition contributing to disability in the United States. Seventy-five percent of
individuals undergoing treatment for this condition experience suboptimal or poor outcomes in the form of
disability and deficits in functional capacity, including strength and endurance of the lumbar musculature.
The most common initial treatments for individuals with chronic LBP are exercise-based rehabilitation,
and pharmacological management in the form of analgesic medications. Although these two
conservative treatment modalities are often concurrently prescribed, the influence of analgesic
medications on the capacity of muscle to adapt in response to exercise is unknown. Importantly, in
healthy individuals, some of these medications have been shown to inhibit muscle protein synthesis,
metabolism, and stem cell function. The influence of medications may explain the variability in muscle-
specific and clinical outcomes associated with exercise-based rehabilitation in this population. To
address these current gaps in the literature, we propose to define medication usage patterns and clinical
outcomes across individuals with chronic low back pain who are participating an exercise-based
rehabilitation program. Specific Aim 1 will investigate the influence of symptom interference,
psychosocial factors, and diagnosis on analgesic medication use relative to exercise in individuals with
LBP. Specific Aim 2 will evaluate the influence of medication type, dose, and timing on exercise
performance. Finally, Specific Aim 3 will determine if medication type, dose, and timing influences the
magnitude of muscle hypertrophy and clinical outcomes after completion of a 12-week resistance
exercise program. Determining the impact of common analgesic medications on muscle hypertrophy,
exercise performance, and clinical outcomes is an important step in optimizing conservative
management in individuals with low back pain. This information will also be applicable to a variety of
musculoskeletal conditions for which similar treatment strategies are employed. This contribution is
significant because it is the first step in a precision medicine approach aimed at establishing appropriate
and targeted exercise and analgesic medication prescriptions for reversing muscle impairments that
obstruct patient recovery. This proposal is innovative because it aims to fill a large gap in knowledge
regarding the influence of analgesic medication on muscle adaptation in individuals with pain and
pathological muscle.
Terms: <Activities of Daily Living><Activities of everyday life><Address><Affect><Analgesic Agents><Analgesic Drugs><Analgesic Management><Analgesic Preparation><Analgesics><Animals><Anodynes><Antinociceptive Agents><Antinociceptive Drugs><Atrophic><Atrophy><Back><Belief><Benzodiazepine Compounds><Benzodiazepines><Blood><Blood Reticuloendothelial System><CNS Nervous System><Central Nervous System><Chemical Dependence><Chronic><Chronic low back pain><Clinical><Clinical Practice Guideline><Complex><Diagnosis><Dorsum><Dose><Drug Addiction><Drug Dependence><Drug Dependency><Drug Prescribing><Drug Prescriptions><Drugs><Exercise><Exercise Tolerance><Exercise based rehabilitation><Exposure to><Fear><Fright><General Population><General Public><Goals><Herniated Disc><Human><Hypertrophy><Impairment><Incidence><Individual><Infiltration><Intermediary Metabolism><Knowledge><Literature><Long term disability><Low Back Ache><Low Back Pain><Low Backache><Lumbago><Measures><Medical Rehabilitation><Medication><Medication Management><Metabolic Processes><Metabolism><Mitochondria><Modality><Modern Man><Muscle><Muscle Cells><Muscle Proteins><Muscle Tissue><Muscle relaxants><Musculoskeletal><Myocytes><NSAIDs><Neuraxis><Non-Steroidal Anti-Inflammatory Agents><Operative Procedures><Operative Surgical Procedures><Opiates><Opioid><Outcome><Pain><Painful><Participant><Pathologic><Patients><Pattern><Performance><Pharmaceutical Preparations><Pharmacologic Management><Population><Prescribed exercise><Prevention><Prognosis><Prolapsed Disk><Protein Biosynthesis><Psychosocial Factor><Recommendation><Recovery><Recurrence><Recurrent><Rehabilitation><Rehabilitation therapy><Reporting><Resolution><Ribosomal Peptide Biosynthesis><Ribosomal Protein Biosynthesis><Ribosomal Protein Synthesis><Risk><Slipped Disk><Spinal><Spinal Column><Spine><Surgical><Surgical Interventions><Surgical Procedure><Symptoms><Time><Torque><Training Programs><United States><Vertebral column><Work><backbone><chronic symptom><clinical practice and guidelines><cost><daily living function><daily living functionality><disability><drug/agent><exercise prescription><exercise program><exercise rehabilitation><exercise training><experience><fitness program><functional ability><functional capacity><health care management><health management><healthcare management><improved><inhibitor><innovate><innovation><innovative><insight><medication prescription><medication therapy management><mitochondrial><muscle hypertrophy><muscle progenitor cell><muscle stem cell><muscular><neurophysiological><neurophysiology><non-steroidal anti-inflammatory drugs><pain killer><pain medication><pain reduction><pain relief><pain reliever><painkiller><persistent symptom><precision medicine><precision-based medicine><prescribed medication><progenitor cell function><progenitor function><programs><protein synthesis><psychosocial><psychosocial variables><reduce pain><rehab management><rehab therapy><rehabilitation management><rehabilitative><rehabilitative exercise><rehabilitative therapy><relieve pain><resistance exercise><resistance training><resolutions><response><ruptured disk><standard of care><stem and progenitor cell function><stem and progenitor function><stem cell function><surgery><treatment strategy>