Michele Crites Battié has dedicated her career to studying spine disorders and lower-back pain. And, despite decades of study, and dedicated research in the field worldwide, she knows plenty of work remains as there is still no consensus on causes, diagnoses and treatment for a condition that debilitates many.
“There are so many studies, and so many discrepancies, and so many controversies and without a common metric, it’s impossible to sort that out,” said Crites Battié, a new Western Research Chair in Musculoskeletal Exercise Mobility and Health.
Crites Battié, who comes to Western by way of the University of Alberta, where she held a Tier 1 Canada Research Chair (CRC) in Common Spinal Disorders, stepped into her new role earlier this month. She will be appointed in the School of Physical Therapy and affiliated with the Bone and Joint Institute.
“My area of interest is common spine disorders, in particular lumbar spinal stenosis and lower-back pain – common conditions of the lumbar spine. There is so much we still don’t understand and one of the big challenges with painful spinal conditions is in the great majority of cases, while everybody has a theory as to what the cause may be, there is very little agreement and no verifiable diagnoses in the vast majority of people who seek care for that problem,” she said.
Back pain is a prevalent problem and it is difficult to develop efficient and effective treatment if you don’t know the underlying pathology, Crites Battié explained. This is partly why there have been so many different treatments for back pain in the past – there are different theories, leaving researchers and health-care professionals to approach treatment in different ways.
“The disappointing aspect of that is there is hardly anything out there that has been shown to be any more effective than doing anything else,” Crites Battié added. “This basically means if you do something, people seem to do only modestly better than if you do nothing at all. It would be very helpful if we could get a handle on what’s behind some of the painful conditions.”
Crites Battié will continue a number of studies after her arrival at Western. One of them constitutes a study of 600 twins, identical and fraternal, for which her team has collected extensive data looking at lifestyle factors, imaging, anatomical features and pain history. A number of individuals in the study have been followed for 15 years and researchers are now looking at factors associated with increased or decreased risk and reporting of back pain.
Another longitudinal study she will continue looks at 800 individuals who have been given a diagnosis of lumbar spinal stenosis with imaging, some of who have developed the full-blown syndrome of clinical lumbar stenosis and others who have not received that label. Crites Battié has five-year follow-up data on the cohort and is looking to analyze the information gathered to determine what is likely to lead to positive outcomes.
“A group of us have also been working for years in developing a common language in the area of outcomes for any treatment. There has been a movement over the last 20 years to come up with consistent outcome measures so when people all over are doing research, at least we have a common metric and we can compare studies,” she added.
“The problem with imaging studies – and I have been involved in a lot of studies that look at pathoanatomy and degenerative changes – is no one has made an effort to develop some common imaging measures so we can speak the same language. At the very least, we need to have a common core measure, so when your results differ from mine, and otherwise the studies look pretty similar, we can interpret that difference a whole lot better. I would like to spearhead that and resource that a bit more at Western.”
A number of things made Crites Battié enthusiastic to continue her research at Western, she noted. For one, the fact the university has decided to designate musculoskeletal health a focus of research made the move an attractive one.
“Musculoskeletal health has been comparatively ignored in research; it’s gotten much less attention but it is a huge, very prevalent problem in terms of lifestyle and disability and it’s really great to see a university decide they’d really like to focus on making a difference in increasing their profile in that area,” Crites Battié said.
“The Bone and Joint Institute at Western is also a really strong group of people in musculoskeletal health and I see all kinds of opportunities for collaboration and learning. I’m really looking forward to working with a new group.”
The university introduced Western Research Chairs in support of its Western Clusters of Research Excellence program in 2013, establishing Cognitive Neuroscience as the first cluster and Musculoskeletal Health as the second. Neuroscientist Ingrid Johnsrude was named the first Western Research Chair in 2014. Last year, Computer Science professor Jörn Diedrichsen was named Research Chair in Motor Control and Computational Neuroscience, and Physiology and Pharmacology professor Tim Bussey was named Research Chair in Cognitive Neuroscience.
Modeled after the CRC program, and in direct support of cluster development, the Western Research Chairs program aims to recruit up to 10 mid- to senior-level researchers to build capacity, enhance collaborative and interdisciplinary research and produce research results with global implications.