Inhibition of Neurogenic Inflammatory Pathways Associated with the Reduction in Discogenic Back Pain

Area of Science:

• Neurology
• Pain Management
• Rheumatology

Background:

• Calcitonin gene-related peptide (CGRP) is implicated in neurogenic inflammation in both migraines and spinal spondylotic disease.
• CGRP antagonists are established migraine treatments, but their effect on discogenic pain is not well understood.

Purpose of the Study:

• To investigate if anti-CGRP medication for migraines improves back/neck pain, mobility, and function in patients with comorbid degenerative spinal disease.
• To explore the potential off-target therapeutic effects of CGRP inhibitors beyond migraine treatment.

Main Methods:

• Retrospective cohort study of 56 adult patients with spinal spondylosis and migraine treated with CGRP inhibitors (2017-2020).
• Collected data on pain, function, mobility, migraine severity, and frequency before and after CGRP inhibitor therapy.
• Utilized paired univariate analysis and Spearman's rho correlation to assess changes and relationships.

Main Results:

• A significant decrease in back/neck pain was observed (from 6.30 to 4.36, p <0.001) after initiating CGRP inhibitor therapy.
• 25% of patients reported functional improvement and 17.5% reported mobility improvement.
• Back/neck pain reduction moderately correlated with functional improvement (ρ=-0.430).

Conclusions:

• CGRP inhibitors demonstrated significant off-target reduction in back/neck pain for patients with chronic migraines and degenerative spinal conditions.
• These findings suggest a potential broader application for CGRP inhibitors in managing chronic pain associated with spinal disorders.