{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T15:03:25Z","timestamp":1779721405980,"version":"3.53.1"},"posted":{"date-parts":[[2026,5,22]]},"group-title":"Pain Medicine","reference-count":50,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007338","name":"The Foundation for Barnes-Jewish Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007338","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIH","award":["S10OD027006"],"award-info":[{"award-number":["S10OD027006"]}]},{"name":"NIH","award":["DK020579"],"award-info":[{"award-number":["DK020579"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with improvements in pain severity, disability, quality of life, and physical function in adults with obesity and chronic low back pain (cLBP), and to explore potential mechanisms.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective, single-arm cohort study.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>Thirty-five adults (median age 41 years; 86% women) with obesity (median BMI 39.9 kg\/m\u00b2) and cLBP initiating GLP-1 RAs (tirzepatide, n=24; semaglutide, n=11).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants completed questionnaires at baseline, 3, 6, 9, and 12 months. The primary outcome was Brief Pain Inventory-Short Form (BPI-SF) pain severity. Secondary outcomes included body mass index (BMI), BPI-SF pain interference, Numerical Rating Scale (NRS) back pain, Oswestry Disability Index (ODI), and Short Form-12 (SF-12). At baseline and 6 months, a subset (n=24) underwent quantitative sensory testing, physical performance testing, and blood draws for inflammatory biomarkers (C-reactive protein, TNF-\u03b1, IL-6, IL-10), adipokines (leptin, adiponectin), and hemoglobin A1c.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over 12 months, BMI decreased by 12.5% (median 39.9 to 34.9 kg\/m\u00b2, 95% CI [-6.6, -4.2]). BPI-SF pain severity improved (median 4.8 to 2.0, 95% CI [-2.1, -0.8]), as did pain interference, ODI, NRS back pain, and SF-12 physical component scores. Hemoglobin A1c, leptin, and C-reactive protein decreased. Adiponectin increased and physical performance improved, but neither reached significance. Experimental pain sensitivity was unchanged.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GLP-1 RAs were associated with clinically meaningful improvements in pain, disability, and quality of life. These findings suggest GLP-1 RAs may be a promising nonsurgical therapy for cLBP; randomized controlled trials are needed to establish causality and mechanisms.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.20.26353666","type":"posted-content","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:35:26Z","timestamp":1779496526000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of GLP-1 Receptor Agonists on Chronic Low Back Pain in Patients with Obesity: A Prospective Pilot Cohort Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-6969","authenticated-orcid":false,"given":"Braeden","family":"Benedict","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dyan","family":"White-Gilliam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryan","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Yakdan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Hammo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Budd","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faraz","family":"Arkam","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon Y.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth B.","family":"Schechtman","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby L.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Robinson Reeds","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burel R.","family":"Goodin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2675-5658","authenticated-orcid":false,"given":"Jacob 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