Aching back can be cured by injecting a gel

Gel that is injected into the spine could prove an alternative to major surgery for the many thousands of people who suffer from lower back pain. Scientists in Manchester plan to test the gel on humans after animal trials have shown it can improve movement. Back pain affects around 80 per cent of people in Britain at some time in their lives, according to the charity BackCare, and is the country’s leading cause of disability.

For between 6 and 8 per cent of the adult population, back pain is caused by degeneration of the discs which hold the vertebrae in the spinal column the right distance apart. This distance is important because nerves pass through openings in the spinal column to other parts of the body, and the discs keep these openings clear. But as a result of wear and tear, the discs lose their ability to keep the vertebrae apart. Strenuous exercise and injuries can make sections of bone break off and damage the disc: it becomes less elastic and a less effective buffer. As a result, the spine compresses and the openings partly close, so bone and disc tissue press on the nerves and cause pain.

Surgeons can treat the problem by removing the sections of disc which are pressing on the nerve. They can also use spinal fusion, welding the vertebrae together in a major procedure which has a considerable recovery time. Fusing the bones together means a loss of flexibility in the spine. Now researchers at the University of Manchester believe they can repair discs by injecting a special gel into the damaged ones. The gel is originally a slightly acid liquid, but contains tiny beads which swell and stiffen when an alkaline substance is added to them. The beauty of the gel is that it can be injected through a tiny aperture into the centre of disc.
When both the liquid and the alkali have been injected in, the gel hardens — this then cushions the vertebrae just as a healthy disc does. Repairing the disc this way means that patients have a shorter recovery time than through surgery, and have restored mobility.

Professor Tony Freemont of the Faculty of Medical and Human Sciences at the University of Manchester, who developed the treatment with Dr Brian Saunders from the university’s School of Materials, says: "Our approach has the advantage of restoring spinal mobility whereas spinal fusion surgery results in a significant loss of mobility at the fused and adjacent discs." Surgery can also carry significant risks, says Dr Mike McKiernan, chairman of the board of trustees at the charity BackCare. "Degeneration of the discs causes serious problems for several hundred thousand people, so this is an interesting new development," he says. "It is exciting new research which will give hope to the hundreds of thousands of people with back pain caused by damaged discs." However, Dr Saunders, who helped to develop the gel, has urged caution as the process will take some time to test fully before it becomes fully available. "Although we are encouraged by our findings, much work lies ahead to develop a viable nonsurgical repair technology to replace spinal fusion as the standard surgical treatment for chronic lower back pain," he says. Scientists now hope that the new treatment will become available in four or five years’ time, following Ethics Committee approval and clinical trials.