# The interaction between analgesic medication and exercise-induced musclehypertrophy in patients with low back pain

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2022 · $387,100

## Abstract

Low back pain (LBP) is a complex condition that affects 65-85% of the population, and is the leading
musculoskeletal condition contributing to disability in the United States. Seventy-five percent of
individuals undergoing treatment for this condition experience suboptimal or poor outcomes in the form of
disability and deficits in functional capacity, including strength and endurance of the lumbar musculature.
The most common initial treatments for individuals with chronic LBP are exercise-based rehabilitation,
and pharmacological management in the form of analgesic medications. Although these two
conservative treatment modalities are often concurrently prescribed, the influence of analgesic
medications on the capacity of muscle to adapt in response to exercise is unknown. Importantly, in
healthy individuals, some of these medications have been shown to inhibit muscle protein synthesis,
metabolism, and stem cell function. The influence of medications may explain the variability in muscle-
specific and clinical outcomes associated with exercise-based rehabilitation in this population. To
address these current gaps in the literature, we propose to define medication usage patterns and clinical
outcomes across individuals with chronic low back pain who are participating an exercise-based
rehabilitation program. Specific Aim 1 will investigate the influence of symptom interference,
psychosocial factors, and diagnosis on analgesic medication use relative to exercise in individuals with
LBP. Specific Aim 2 will evaluate the influence of medication type, dose, and timing on exercise
performance. Finally, Specific Aim 3 will determine if medication type, dose, and timing influences the
magnitude of muscle hypertrophy and clinical outcomes after completion of a 12-week resistance
exercise program. Determining the impact of common analgesic medications on muscle hypertrophy,
exercise performance, and clinical outcomes is an important step in optimizing conservative
management in individuals with low back pain. This information will also be applicable to a variety of
musculoskeletal conditions for which similar treatment strategies are employed. This contribution is
significant because it is the first step in a precision medicine approach aimed at establishing appropriate
and targeted exercise and analgesic medication prescriptions for reversing muscle impairments that
obstruct patient recovery. This proposal is innovative because it aims to fill a large gap in knowledge
regarding the influence of analgesic medication on muscle adaptation in individuals with pain and
pathological muscle.

## Key facts

- **NIH application ID:** 10458668
- **Project number:** 5R01HD100446-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Bahar Shahidi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $387,100
- **Award type:** 5
- **Project period:** 2020-09-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10458668

## Citation

> US National Institutes of Health, RePORTER application 10458668, The interaction between analgesic medication and exercise-induced musclehypertrophy in patients with low back pain (5R01HD100446-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10458668. Licensed CC0.

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