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J Am Acad Orthop Surg, Vol 12, No 2, March/April 2004, 106-115.
© 2004 the American Academy of Orthopaedic Surgeons
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Low Back Pain: Pathophysiology and Management

Ashok Biyani, MD and Gunnar B. J. Andersson, MD, PhD

Dr. Biyani is Assistant Professor, Department of Orthopedic Surgery, Medical College of Ohio, Toledo, OH. Dr. Andersson is Professor and Chairman, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL.

Reprint requests: Dr. Andersson, Rush University Medical Center, 1750 W Harrison Street, 1471 J, Department of Orthopedic Surgery, Chicago, IL 60612.

Basic research is advancing the understanding of the pathogenesis and management of low back pain at the molecular and genetic levels. Frequently, low back pain is caused by disorders of the intervertebral disk. Cytokines such as matrix metalloproteinases, phospholipase A2, nitric oxide, and tumor necrosis factor-{alpha} are thought to contribute to the development of low back pain. Drugs are being developed to modulate these chemical mediators. Recent research using growth factors to promote chondrocyte regeneration appears to be promising. Advances in gene therapy to both prevent disk degeneration and regenerate the disk eventually may have clinical application.






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Copyright © 2004 by the American Academy of Orthopaedic Surgeons.