1000 Section - GLP-1 Implications for PM&R: A Novel Case Study of Functional Recovery in Chronic Low Back Pain

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

IG

Isabella L.Y. Guilfoyle, BS

MD Candidate, Class of 2029
California University of Science and Medicine
Redlands, California, United States

Co-Author(s)

FJ

Francesca Johnson, BS

Medical Student
California University of Science and Medicine
Colton, California, United States
MC

Mehul Chowdarapu, BS

MD Candidate, Class of 2028
California University of Science and Medicine
San Bernardino, California, United States
VJ

Vance Z. Johnson, MD

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

Case Diagnosis: Chronic low back pain (CLBP) remains a major cause of disability, frequently persisting despite multimodal treatment. Emerging evidence implicates neurobiological mechanisms of chronic pain, including neuroinflammation, central sensitization, and altered pain–mood circuitry. Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used for metabolic disease, they demonstrate CNS effects. This novel case examines the association between GLP-1RA and functional recovery in a patient with longstanding CLBP refractory to conventional PM&R-directed care.

Case Description: A 69-year-old female with CLBP for 10 years was treated for flare-ups in a university PM&R spine clinic over 7 years via conservative treatments that yielded partial, transient improvement. Her clinical course included flare-ups 1-2 times per year, lasting 4-6 months, with pain reaching 8/10 on Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) exceeding 30 points above baseline. GLP-1RA was initiated by an external provider for metabolic indications, with no changes to pain/rehabilitation management, or psychiatric therapy.

Discussions: In 6-8 weeks of GLP-1RA initiation, pain improved VAS 8/10 to 2/10, and ODI decreased over 50%, surpassing thresholds for clinically meaningful improvement. Weight loss was minimal, suggesting alternative biomechanical unloading mechanisms. Preliminary GLP-1RA studies demonstrated that increased signaling can modulate neuroinflammation and neurotransmitter systems involved in chronic pain. The substantial and sustained improvement ( >6mo.) in this case suggests a potential effect on underlying pain mechanisms rather than temporary relief. This single case cannot establish causality but stimulates investigation.

Conclusions: This case highlights marked and sustained improvement in chronic low back pain and functional disability associated with GLP-1RA in a patient with CLBP despite comprehensive care. These preliminary findings underscore potential roles for GLP-1RA as future adjunctive pain rehabilitation. Our research suggests this is the first such report to encourage further evaluation of GLP-1RAs on CLBP and function.