# Forced Convection as a Rehabilitation Strategy for Arresting Low Back Pain

> **NIH VA I01** · STRATTON VETERANS ADMIN MEDICAL CENTER · 2020 · —

## Abstract

Low back and neck pain are the leading cause of chronic disability world-wide and they are among the
most prevalent chronic musculoskeletal conditions in the United States Military and Veteran populations.
Physical therapy and rehabilitation are effective at eliminating acute symptoms in most patients, but the
number of patients with recurring back and neck pain is also high. Most commonly, back and neck pain are
associated with degeneration of the intervertebral disc.
 The disc is avascular and relies on passive diffusion for uptake of critical nutrients and clearance of harmful
byproducts. The disc's ability to repair and regenerate is constrained largely by its limited uptake of these
nutrients and clearance of byproducts.
 More than four decades ago, convection (bulk flow) was explored as a possible strategy to augment
diffusion and enhance uptake and clearance of small molecules to/from the disc. Based on these studies, the
predominant opinion in the literature for four decades has been that convection does not contribute to the
transport of small molecules in the intervertebral disc.
 Through our award winning research, we have recently disproven the long-standing belief that convection
cannot augment diffusion. In fact, using the appropriate protocols, our exciting new results demonstrate that
convection can augment diffusion for transport of small molecules to/from the disc. Our results also suggest a
novel therapeutic approach to enhance the metabolic activity of the disc and tip the balance away from
degeneration toward regeneration.
 While we have demonstrated enhanced uptake and clearance and enhanced biosynthesis in the disc
through our approach, we have not yet optimized the loading parameters to most effectively enhance transport
at all stages of degeneration.
 In the proposed study, we will optimize the loading parameters to most effectively enhance transport at all
stages of degeneration in an animal model. We will also determine the effectiveness of our approach to treat
discs through the entire spectrum of degeneration from early stage to significantly degenerated.
 Results from the proposed research will advance our therapeutic strategy toward translation to clinical
trials. Ultimately, this research will lead to the development of motion-based weight bearing exercise regimens
that arrest or reverse disc degeneration in Veterans.

## Key facts

- **NIH application ID:** 9873834
- **Project number:** 5I01RX002148-04
- **Recipient organization:** STRATTON VETERANS ADMIN MEDICAL CENTER
- **Principal Investigator:** ERIC H LEDET
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-03-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9873834

## Citation

> US National Institutes of Health, RePORTER application 9873834, Forced Convection as a Rehabilitation Strategy for Arresting Low Back Pain (5I01RX002148-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9873834. Licensed CC0.

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