The Dynamics of the Spine: Mechanics, Morphology and Motion towards a Comprehensive Diagnosis of Low Back Pain
Lower back pain is one of the most common diseases of the musculoskeletal system. It is therefore of great medical, social and not least economic importance. The interdisciplinary research group "The dynamics of the spine: mechanics, morphology and movement for a comprehensive diagnosis of back pain" aims to gain fundamental new insights into how back pain develops in order to improve diagnosis and therapy. To this end, the consortium brings together researchers from various disciplines and plans to study 3,000 subjects with and without back problems. The spokesperson of the newly established DFG research group is Professor Dr. Hendrik Schmidt from the Julius Wolff Institute of the Berlin Institute of Health at the Charité (BIH).
Two out of three people are affected by back pain in the course of their lives," says Professor Hendrik Schmidt, the head of the "Biomechanics of the Spine" working group at the Julius Wolff Institute of the Berlin Institute of Health at Charité (BIH). "And we still can't predict exactly who will be affected. Because back pain has many causes. We now want to get to the bottom of these."
Many reasons for back pain
The reasons why the back starts to hurt are indeed manifold: known causes include lack of exercise and obesity, incorrect posture at work, frequent and incorrect lifting and carrying of loads. In addition, certain physical illnesses can also promote back pain. Stress and everyday worries also leave their mark on our backs, because in addition to physical illnesses, mood, learning processes and psychological stress can also be linked to pain in the back. Less is known about genetic principles, biochemical mechanisms, social triggers or the interaction of several factors.
"Accordingly, we cannot yet offer every patient an individually adapted therapy," explains Schmidt. Currently, a clinical diagnosis is made for back complaints on the basis of a one-time physical examination and/or imaging procedures such as MRI and X-ray, and thus certain therapies are recommended. However, these static "snapshots" in an environment that is foreign to the patients do not provide sufficient information about the underlying mechanisms of back complaints. This very often results in wrong diagnoses and therapy decisions that turn out to be "therapy failures" in the later course. "We want to improve this unsatisfactory situation through scientific studies. In the future, the spine must be understood as an organ system "with dynamic function" and biochemical and psychosocial correlations must be included. We want to move from a static short-term analysis ("snapshot") to a dynamic image of the spine and collect measurements for posture and the movement profile in everyday life. Only in this way can we avoid "therapy failure" in the future."
3000 test persons wanted
For their comprehensive project, Hendrik Schmidt and his co-spokespersons Professor Dr Sara Checa from the Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration and Professor Dr Christoph Stein from the Clinic for Anaesthesiology with a focus on Surgical Intensive Care Medicine at the Charité Campus Benjamin Franklin. Christoph Stein from the Department of Anaesthesiology with a focus on Operative Intensive Care Medicine at the Charité Campus Benjamin Franklin have called together representatives from biomechanics, orthopaedics and trauma surgery, exercise and movement sciences, anaesthesiology, pharmacology, mathematics and health psychology from the Charité - Universitätsmedizin Berlin, the Humboldt-Universität zu Berlin, the Medical School Berlin and the Zuse Institute to form the new DFG research group. "We want to develop a joint approach. We plan to work together with Priv.-Doz. Dr. Matthias Pumberger from the Centre for Musculoskeletal Surgery to thoroughly examine a total of 3,000 test subjects with and without back pain to find out where the problems stem from," says Christoph Stein. The programme includes a magnetic resonance imaging (MRI) scan, orthopaedic examinations, gait analyses, short- and long-term functional analyses and questionnaires on nutrition, exercise profile, psychological and social situation, experimental studies and biometric measurements, such as height and weight.
Individualised treatment as the goal
"Our first goal is to clarify the role and interaction of morphology, movement and mechanics in the lower back, i.e. the lumbar spine and pelvis," explains Sara Checa. "In the next step, we would then like to find out how individual parameters such as age, gender and anatomy, as well as biochemical and psycho-social factors, contribute to the development of back pain." Animal experiments as well as mathematical models will complement the studies with human subjects. The scientists will use modern "machine learning" systems with artificial intelligence to combine and analyse the large amounts of different data collected in this way.
"We hope, of course, that these complex studies will open up new possibilities for diagnosing back pain clinically and planning individual treatment," says Hendrik Schmidt. "And thus to be able to successfully counter the widespread disease "back pain"."
Test persons aged 18 to 64 years with and without back pain are being sought for the study. The study is expected to begin on 01.01.2022. Information is available at jwi.charite.de/research/research_biomechanics_at_organ_level/biomechanics_of_the_spine/
About the DFG Research Groups:
Research groups enable scientists to address current and pressing questions in their fields and to establish innovative working directions. In total, the DFG currently funds 173 research groups, 14 clinical research groups and 13 collegiate research groups. Clinical research groups are additionally characterised by the close link between scientific and clinical work, while collegiate research groups are specifically tailored to forms of work in the humanities and social sciences.
Text source: Press release of the BIH
Prof. Dr. Hendrik Schmidt
BIH - Julius Wolff Institut
Augustenburger Platz 1
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