Researchers from UC Berkeley and UC San Francisco are exploring the intricacies of chronic low back pain through their study, comeBACK. The study, aimed at enhancing personalized treatment for sufferers, focuses on understanding the correlations between movement and pain and how these differ between men and women.
The study’s findings, published in the European Spine Journal, demonstrate an unexpected difference between the sexes. Although men show less sensitivity to low back pain, they exhibit poorer movement quality and are less active. This surprising conclusion emerged from tests using full-body motion capture and pressure pain threshold assessments.
Jeannie Bailey, professor of orthopedic surgery at UCSF, noted, “With chronic low back pain, in general, it’s hard to know what the underlying cause is.” Oftentimes, imaging such as MRIs does not reveal the cause, complicating treatment decisions. Bailey emphasized the complexity by stating, “Sometimes there’s no obvious indicator from imaging, like an MRI, so you don’t know what’s causing the pain.”
Grace O’Connell, a Berkeley professor of mechanical engineering, highlighted that degenerative changes do not always correlate with pain. “As we get older, our tissues degenerate, our spine degenerates,” she explained, indicating that these conditions might not be the pain’s cause, thus complicating treatment strategies.
Bailey detailed their findings, saying, “We actually showed that lower pain sensitivity in males correlated with worse biomechanical function.” This observation led her to conclude that females are more reactive and move better due to higher pain sensitivity. The researchers did not see a discrepancy in self-reported pain levels but noticed a pattern in actual sensitivity testing. O’Connell attributed recent attention to sex-based differences to initiatives by bodies like the National Institutes of Health, stating, “I also think there’s been a push to look at sex as a variable.”
Bailey suggested that women might underreport pain due to cultural norms and noted, “I think women are adapted to be more used to pain because of evolution.” A deeper understanding of low back pain, informed by these findings, could lead to more effective treatment options. As Bailey explained, “Better understanding the heterogeneous population of chronic low back pain patients will probably help us inform treatment selections that will work better.”
As the study progresses, researchers hope to tailor treatments more precisely, considering whether physical therapy, biopsychosocial methods, or other therapies are appropriate for individual cases.
