Media contact: Hannah Echols
University of Alabama at Birmingham 
Edwin Aroke, Ph.D., will examine factors, including epigenetics, that play a role in chronic lower back pain in order to improve the quality of life for patients.
(Photography: Frank Couch)School of Nursing Assistant Professor Edwin Aroke, Ph.D., CRNA, will study chronic low back pain through a four-year, $1.7 million R01 grant from the National Institutes of Health. Aroke will examine the role of epigenetics in the presence and persistence of non-specific chronic back pain, especially for Black individuals.
During the study, Aroke will analyze blood samples to study the role of epigenetic changes that may cause and sustain racial differences in chronic lower back pain. Epigenetics is the study of genes that can become activated or silenced within the body in response to environmental factors. His findings from the study will inform future research for treatments and interventions for low back pain.
“We believe that Black and Brown people have more stressful life experiences,” Aroke said. “Each time the body goes through stress, it gives a signal to produce stress hormones — like cortisol — to allow the body to manage, and epigenetic changes are ways by which the body activates the genes to produce stress hormones. When you experience a lot of stress, however, the body can fail to adapt after an insult or face what we call ‘wear and tear.’”
Chronic low back pain, categorized as back pain lasting more than 12 weeks, is one of the most common forms of pain experienced in the United States. Studies show chronic low back pain can lead to costs from lost wages, reduced productivity and more, amounting to about $100 billion annually. The exact cause of chronic low back pain is unknown for most individuals, and they are said to have non-specific chronic low back pain.
Aroke says the generational inheritability of some epigenetic changes could account for higher levels of cortisol. He will also examine how psychosocial factors, or social standing, may play a role in back pain, including how depression stigma and anxiety disproportionately impact U.S. residents who identify as African American or Black more than other racial or ethnic groups.