1301 - GLP-1 in Pain Medicine? First Clues for Back Pain Treatment

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

VJ

Vance Z. Johnson, MD

Professor of Medical Education
California University of Science and Medicine
Temecula, California, United States

Co-Author(s)

FJ

Francesca Johnson, BS

MD Candidate
California University of Science and Medicine
Temecula, California, United States
EI

Ethan Izu, MD

Resident Physician PGY-1
Riverside Community Hospital
Irvine, California, United States

Submitter(s)

VJ

Vance Johnson, MD

California University of Science and Medicine
TEMECULA, California, United States

Case Diagnosis: Intractable Chronic Axial Lumbago Overweight

Case Description: A 63-year-old male with BMI 28 presented to a physical medicine and rehabilitation clinic with over 10 years of intractable axial low back pain. He had initiated GLP-1 receptor agonist therapy for weight management. In just a month, he reported a greater than 50% reduction in back pain and improved physical function despite only losing 7 lbs. so far. No prior interventions had achieved similar pain relief. His pain relief began before his weight loss and continued to improve in the first 3 months of GLP-1 use without adding or changing any treatment or other lifestyle variables. He followed up at 6 months having stopped the GLP-1 for 6 weeks and noted returning pain without having regained the lost weight. He credited the GLP-1 and went back on it with repeat relief pattern.

Discussions: This case is unique in the medical literature: there are no prior reports of substantial chronic low back pain reduction coincident with GLP-1 receptor agonist therapy in this clinical context. GLP-1 receptor agonists are known to increase microvascular blood flow in muscle, improve myocyte metabolism, inhibit muscle atrophy, and promote skeletal muscle remodeling and endurance. These mechanisms may contribute to improved muscle perfusion, reduced inflammation, and enhanced muscle function, potentially explaining the observed pain reduction.

Conclusions: This case highlights a novel and previously unreported association between GLP-1 receptor agonist therapy and significant improvement in chronic low back pain. The observed effects may be mediated by enhanced muscle microvascular perfusion, metabolism, and anti-inflammatory actions. Further research is warranted to investigate GLP-1’s potential role in musculoskeletal pain management and rehabilitation.