Fluorescently labeled molecules target unfurled collagen proteins to create detailed images and 3D maps of damaged soft tissues in the spines of mice and rats. Credit
American Chemical Society

Back pain affects many people at some point in their lives, and a common cause is damage to the squishy discs or flexible, rubbery tissues of the spine. However, observing this damage at an early stage is difficult with current imaging methods. Now, researchers reporting in ACS Nano can see microscopic soft tissue destruction in animal spines by targeting denatured collagen with fluorescent molecules.

Anywhere along the spine, from the neck to tail bone, can become uncomfortable when its soft and protective tissues, including the cartilage and jelly-like intervertebral discs, become damaged and lose their structure. Daily wear-and-tear, as well as some disorders, such as facet joint osteoarthritis or ankylosing spondylitis, can degrade and unfurl the collagen proteins that give these tissues their bounce and flexibility. Detecting compromised collagen early could help patients get relief before the pain becomes severe, but this is very difficult to do with existing medical technologies, such as X-rays and magnetic resonance imaging (MRI). Previously, Yang Li and colleagues developed a collagen hybridizing peptide (CHP) probe that specifically binds unfurled collagen molecules, which happens when they deteriorate and lose their ability to cushion vertebrae. So, Li, Kuibo Zhang, Hong Shan and colleagues wanted to test if CHP labeled with fluorescent tags could be used as an imaging method to identify collagen destruction in the body.

To make the peptide probe more stable in the body, the researchers modified CHP by substituting a hydroxyl group with fluorine and then attaching a fluorescent dye to it. When healthy mice and rats were injected with the fluorescent dye-labeled CHP and imaged with near-infrared fluorescence (NIRF), the team could confirm that the fluorescing molecules accumulated on the soft tissues between the vertebrae. Then the researchers removed a portion of the animals’ spines and imaged them with light sheet fluorescence microscopy. This technique produced precise 3D maps, which revealed denatured collagen. Because CHP is known to specifically target damaged collagen, the team says their imaging experiments show that even healthy animals can have a modest degree of deteriorated collagen around load-bearing joints, especially in the lower back. In additional experiments, both the NIRF images and 3D maps generated with the new method detected collagen deterioration in animal models of spinal injury before structural changes were visible in tissues on MRI scans. Finally, the researchers applied dye-labeled CHP as a stain to intervertebral disc slides from people that had undergone spinal surgeries. The fluorescence intensity of the stain rose substantially as the level of disc degeneration increased. Based on these results, the researchers say that their molecular-level technique could be developed in clinical studies for earlier diagnosis and targeted therapeutic treatments for patients with back pain.

Know the signs to look for to know when you need to call your doctor about your back pain and when to just rest.

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Are you suffering from bad back pain? If yes, it’s more than likely that you’ve ventured onto the web to find out what’s caused your back pain and how you can alleviate it. New research into these searches, conducted by OTTY Sleep, reveals our biggest back pain queries and where in the UK people suffer the most from a bad back.

The data comes just two months after it was announced a number of patients are still waiting upwards of a year for help for chronic back pain. Understandably, the pandemic has put more pressure on NHS services than ever, so it’s important to understand how our back pain is being caused and how we can alleviate the pain.

Here, we explore the cities with the biggest back-breaking problems, how these issues may have been caused, and how you can help alleviate the pain and treat the problem.

Back-breaking Belfast

The research compared Google searches across the 20 most populated cities in the UK. Each city was probed for how often they searched for back pain-related terms. In total, 116 search terms were analysed for their search frequency, identifying our biggest back-breaking problems, our growing pains, and which city was most likely to feel the effect of spinal aches and back-busting agony.

The study found that people in Belfast were the most likely to suffer from back pain. For every 100,000 people in the Northern Irish capital, 742 people searched for a back pain-related term every month. This is 36 per cent above the average city. Of the back pain search terms, people in Belfast were most likely to search for ‘back pain middle’, perhaps indicating where the main issue with their back pain lies.

Belfast was followed by Newcastle upon Tyne and Glasgow as the next most back pain suffering cities. They searched for back pain related terms 27 per cent and 20 per cent more than the average city respectively. People in Newcastle sought out ‘exercises for lower back pain’ while Glaswegians searched for ‘back stretches’ over any other back pain related terms.

For other cities, back pain was less of a sore issue. People in London only searched for back pain 353 times for every 100 thousand people – 35 per cent below average. Cardiff and Bradford also suffered less than average back pain; their back pain searches were 35 per cent and 16 per cent below the average UK city.

The causes of back pain

Searches for back pain-related terms increased in 14 of the top 20 most populated cities in the UK. So, what are the causes of back pain? And is there a reason why these city people are feeling more back pain?

We can’t always identify the root cause of back pain. Most back pain is categorised as “non-specific”, meaning that the cause isn’t obvious. However, most pain will originate from the joints, bones, or soft tissue around the spine. For the purpose of identifying causes of back pain, we’ll stay away from broken bones and infections — the cause is fairly obvious in those cases.

Non-specific back pain can vary based on our position, will often feel worse when we’re moving, and can appear suddenly or gradually. The most common causes of this type of back pain include:

• Poor posture
• Lifting something awkwardly
• A minor injury, such as a sprain or strain
• Feelings of stress or fatigue

But why do some cities experience worse back pain than others? And what’s changed in the past year to cause this?

As stated, our health and lifestyle are linked to our back pain. Exercise and quality sleep are therefore integral for alleviating back pain. Interestingly, previous OTTY research has found that Belfast has more trouble sleeping than other major UK cities. This mirrors Belfast as the UK city with the most back pain. Could then our sleep quality be linked to our back pain?

In the past year, feelings of fatigue have also increased. Spurred on by the stress of the pandemic and the effects of COVID-19 and its long-term symptoms, muscle tiredness is becoming a concern for many who have suffered from the virus. The study shows that Leicester increased their searches for back pain related terms by 37 per cent in the past year, more than any other city. Therefore, the pandemic may have also contributed to a back pain epidemic in the UK. Not to fear, most back pain is reversible and can be easily treated.

Putting the pain to rest

As your back pain can be related to your health and lifestyle, it’s important to tackle these issues head-on to alleviate your spinal sores. In essence, fixing back pain lies in ensuring you’re well-rested and that your back has the strength to do all the activities you want to do in the day.

Exercise

We know that you probably won’t feel like it when you’re in pain, but exercise is very important when treating back pain. You should aim to exercise at least three times a week. This can be as simple as a brisk walk for thirty minutes. Over time, you’ll be building strength in your spine.

Idleness allows the muscles around the spine and in the back to become weak. In turn, this means that your spine is less supported, and it becomes more difficult to hold your body in good posture, further leading to more pain.

Quality rest

Poor sleep and fatigue can also contribute to back pain. It’s important that we get the rest we need; otherwise, our muscles do not have time to repair and strengthen. This begins with ensuring you’re getting around seven to nine hours of sleep per night.

An uncomfortable bed may also be contributing to your sleep and back pain issues. A hybrid mattress is recommended for supporting your body during sleep, spreading out pressure and conforming to your body and sleeping position. This allows your muscles to fully rest and repair at night.

General health

While sleep and exercise can go a long way to alleviate and treat your back pain, of course, our general health must improve to help with back pain.

Research has shown that current smokers have a higher occurrence of back pain than former or non-smokers. Meanwhile, our body weight can contribute to back pain. One pound of weight gain can cause four pounds of pressure on your spine.

If you’re looking to help your back pain, quitting smoking and losing weight should be a priority.

Whether you live in Belfast or London, back pain can be a huge issue for many people who suffer this problem. Of course, not all back pain can be cured by exercise and quality sleep. Seeing your GP may be the best option for some people. However, getting yourself out for a walk, finding a new mattress, and living a healthier lifestyle is a good place to start.

Bio:

Beth Riley is a Content Manager at OTTY Sleep, covering topics surrounding sleep and the many factors that play a part in us getting the important deep rest needed to keep us rejuvenated and functioning at our best.