Kjell Olmarker research group
Low back pain (lumbago) with or without sciatica (ischias), affects up to about 80 % of all people sometime during life. These conditions result in suffering for many individuals and major costs for society in terms of inability to work, medical treatment and rehabilitation. The total cost in Sweden for back pain in 1995 was estimated to SEK 29.4 billion (miljarder kronor). Low back pain and sciatica usually has a good prognosis and most people are able to return to work within 3-4 months. However, a considerable number of individuals still have long-lasting low back pain. The knowledge regarding underlying causes for these spinal pain conditions is incomplete. Because of this apparent lack of knowledge it is often difficult to define specific treatment modalities. Increased knowledge about underlying mechanisms for spinal pain conditions can be expected to lead to improved diagnostic and treatment modalities for these patient categories.
In this project long-term research is undertaken in order to clarify the pathophysologic mechanisms of low back pain and sciatica. Our research group was the first group in the world to demonstrate that autologous disc tissue (nucleus pulposus) can induce structural and functional nerve root injury without mechanical compression. Recent investigations in the project have shown that cytokines such as tumor necrosis factor (TNF) are involved in the pathogenesis of sciatic pain. This has resulted in clinical trials on the use of TNF-inhibition to treat sciatica. The project will study 1) the pathophysiology of sciatica with special emphasis on events upstream of TNF, 2) the pathophysiologic mechanisms of low back pain with emphasis on the role of disc leakage without nerve root engagement as a cause of low back pain and 3) changes in gene-expression in nucleus pulposus-cells following disc herniation.
The development of symptoms and signs in cases of low back pain/sciatica is often related to various forms of involvement of spinal nerve roots. Our research is internationally established as leading in studies regarding mechanical and biochemical injury of spinal nerve roots as well as in studies regarding pain mechanisms in nerve root involvement in various spinal degenerative disorders. The research program in this application is thus based on extensive experience from more than 25 years of research in these fields.
Kjell Olmarker, MD PhD, group leader, professor
Åsa Blixt PhD, postdoc