Low back pain is the second most frequently diagnosed pain condition in the United States and even after receiving health care treatment an estimated 40% of patients will experience persistent low back pain. Accurate detection of patients at increased risk for persistent low back pain and the delivery of effective interventions could save the United States billions of dollars each year in health care expenses and lost productivity, and improve quality of life for millions of Americans. Although a precise structural etiology of persistent low back pain is rarely present, recent studies report functional alteration in the peripheral and central nervous system of patients with persistent low back pain that are associated with enhanced pain sensitivity. It has recently been shown that genetic polymorphisms and modifications in gene expression patterns can influence pain sensitivity;however, this has never been studies in patients with low back pain. Therefore, the proposed study will investigate the role of enhanced pain sensitivity on the risk of persistent LBP through characterization of pain sensitivity and pain-sensitivity candidate gene profiling.

Public Health Relevance

Persistent low back pain affects nearly 36 million Americans every year. Although many times there are no identifiable reasons for low back pain, prior studies have shown that there are changes within the peripheral and central nervous system that may result in the persistence of pain. The proposed research study will examine the changes that occur in the peripheral and central nervous system during an episode of low back pain through pain sensitivity testing and by measuring genetic factors that influence pain sensitivity and evaluate whether these strategies can help to determine the risk of persistent low back pain so that preventative interventions and treatments may be initiated.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Research Project (R01)
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Special Emphasis Panel (ZRG1-NRCS-G (08))
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Marden, Susan F
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Virginia Commonwealth University
Other Health Professions
Schools of Nursing
United States
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Ramesh, Divya; D'Agata, Amy; Starkweather, Angela R et al. (2018) Contribution of Endocannabinoid Gene Expression and Genotype on Low Back Pain Susceptibility and Chronicity. Clin J Pain 34:8-14
Young, Erin E; Kelly, Debra Lynch; Shim, Insop et al. (2017) Variations in COMT and NTRK2 Influence Symptom Burden in Women Undergoing Breast Cancer Treatment. Biol Res Nurs 19:318-328
Starkweather, Angela; Julian, Thomas; Ramesh, Divya et al. (2017) Circulating Lipids and Acute Pain Sensitization: An Exploratory Analysis. Nurs Res 66:454-461
Starkweather, Angela; Kelly, Debra Lynch; Thacker, Leroy et al. (2017) Relationships among psychoneurological symptoms and levels of C-reactive protein over 2 years in women with early-stage breast cancer. Support Care Cancer 25:167-176
Ferranti, Erin P; Grossmann, Ruth; Starkweather, Angela et al. (2017) Biological determinants of health: Genes, microbes, and metabolism exemplars of nursing science. Nurs Outlook 65:506-514
Starkweather, Angela R; Ramesh, Divya; Lyon, Debra E et al. (2016) Acute Low Back Pain: Differential Somatosensory Function and Gene Expression Compared With Healthy No-Pain Controls. Clin J Pain 32:933-939
Wright, Michelle L; Dozmorov, Mikhail G; Wolen, Aaron R et al. (2016) Establishing an analytic pipeline for genome-wide DNA methylation. Clin Epigenetics 8:45
Starkweather, Angela R; Heineman, Amy; Storey, Shannon et al. (2016) Methods to measure peripheral and central sensitization using quantitative sensory testing: A focus on individuals with low back pain. Appl Nurs Res 29:237-41
Lyon, Debra E; Cohen, Ronald; Chen, Huaihou et al. (2016) The relationship of cognitive performance to concurrent symptoms, cancer- and cancer-treatment-related variables in women with early-stage breast cancer: a 2-year longitudinal study. J Cancer Res Clin Oncol 142:1461-74
Wright, Michelle L; Starkweather, Angela R; York, Timothy P (2016) Mechanisms of the Maternal Exposome and Implications for Health Outcomes. ANS Adv Nurs Sci 39:E17-30

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