Project Details
Projekt
SP1 Dynamic Diagnostics and Mechanisms of Chronic Low Back Pain – Optimization of Analytical Methods and Clinical Insights
Subject Area
Orthopaedics, Traumatology, Reconstructive Surgery
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 439742772
During the first funding period of FOR 5177, a comprehensively characterized study cohort of over 2,500 participants was established. This cohort includes asymptomatic individuals as well as those experiencing acute, intermittent, or chronic low back pain (cLBP), with or without accompanying functional and/or morphological changes in the lumbar spine. In addition to clinical examinations and MRI imaging, 24-hour measurements of spinal posture and movement during daily activities, gait analyses, and extensive psychosocial assessments (e.g., pain characteristics, quality of life, psychological stress, and social factors) were conducted. Our analyses revealed that functional abnormalities in cLBP patients occur less frequently at the site of pain in the lumbar spine itself and are more often detected in adjacent regions, particularly the thoracic and cervical spine as well as the pelvis. For example, reduced hip and cervical spine mobility demonstrated a strong association with cLBP. Beyond mobility deficits in neighboring regions, we identified eight additional key parameters that reliably distinguish between individuals with and without cLBP; these include psychosocial stressors and structural alterations (e.g., intervertebral disc degeneration). Whereas the first funding period focused on systematically capturing structural, functional, and psychosocial characteristics, the second funding phase will emphasize an in-depth analysis of compensatory mechanisms in adjacent musculoskeletal regions; from the thoracic and cervical spine to the pelvis and lower extremities. The aim is to identify muscular and biomechanical adaptation strategies that may contribute to the chronification of low back pain. We hypothesize that compensatory changes in neighboring body regions, detectable at an early stage, combined with structural and biopsychosocial parameters, will serve as robust predictors of pain chronification. These insights are critical for subtyping cLBP, a central step toward addressing clinical heterogeneity, enabling more precise diagnoses, and developing more effective, personalized therapies. The substantial heterogeneity of our study cohort, in terms of pain trajectory, pain localization, functional limitations, and morphological changes, represents a decisive advantage at this stage: it allows for the analysis of complex interactions and faithfully reflects clinical reality. This heterogeneity provides the foundation for identifying distinct mechanisms underlying specific subgroups of low back pain patients. In the second funding period, SP1 will continue to play a central role in the recruitment, systematic characterization, and targeted assignment of participants to the thematically focused subprojects. This approach ensures a structured, hypothesis-driven investigation across the entire research consortium.
DFG Programme
Research Units
Subproject of
FOR 5177:
The Dynamics of the Spine: Mechanics, Morphology and Motion towards a comprehensive Diagnosis of Low Back Pain
Co-Investigator
Professorin Dr. Lena Fleig
