Chronic back pain may have coincided with hormone treatment, scientists say

A hormone traditionally used to treat bone loss may be the key to stopping chronic back pain at its source, according to a new study.

Chronic back pain is often related to deterioration of the spinal discs and the endplates of the vertebrae, which are the thin layers of tissue that separate the discs from the vertebrae, according to medical sources.

When these break down, they become porous, allowing normally unaffected nerves to enter the center of the spine, causing frequent discomfort.

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Research led by Dr. Janet L. Crane of Johns Hopkins University found that parathyroid hormone (PTH) could prevent and even reverse the growth of pain-sensitive nerves in damaged areas of the spine.

The parathyroid glands naturally produce PTH, which experts say plays a key role in regulating calcium levels and bone remodeling.

According to the scientists, these findings could shift the focus of back pain treatment from controlling symptoms to modifying the underlying problem.

“During spinal degeneration, pain-sensing nerves grow in regions where they normally do not exist. Our findings show that parathyroid hormone can reverse this process by activating natural signals that move these nerves away,” Crane said in a news release.

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Synthetic versions of PTH are already used to treat osteoporosis. Previous research hinted that these treatments could also reduce bone-related pain, but the underlying biological mechanism was not well understood.

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Using animal models, Johns Hopkins researchers found that one to two months of PTH treatment led to denser, more stable vertebral endplates.

More importantly, the treatment caused bone-forming cells, known as osteoblasts, to produce a protein called Slit3, the study detailed.

The study found that this protein repels growing nerve fibers, preventing them from infiltrating sensitive regions of the spine.

When the researchers removed Slit3 from mice, the hormone’s analgesic effects disappeared, confirming the protein’s critical role in the process.

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PTH is already approved by the Food and Drug Administration to treat osteoporosis. Some patients receiving the bone density hormone have reported unexpected relief from back pain, a phenomenon this study could help explain.

“Our study suggests that PTH treatment of [lower back pain] during spinal degeneration can reduce aberrant innervation (abnormal nerve growth),” Crane concluded.

The doctor said this research lays the foundation for future clinical trials that will explore the effectiveness of PTH as a disease-modifying treatment and pain relief for spinal degeneration.

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The researchers noted several limitations, including the possibility that PTH treatment could affect the central nervous system in ways that were not fully explored in this study.

Because the study focused specifically on the Slit3 protein, more research is needed to determine how other genetic factors and bone-forming processes might influence spinal nerve growth and pain relief.

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The study was published in the journal Bone Research.