Methods for treating back or neck pain caused by NGF using a therapeutic agent consisting of ReN-1820, ALE-0540 and capsaicin

A method for treating back or neck pain with or without radiculopathy wherein the pain is caused by NGF, the method consisting of:

• providing a therapeutic agent consisting of an effective amount of ReN-1820, ALE-0540 and capsaicin encapsulated in a depot comprising microbubbles comprising a protective coating for timed local release and having a polymer comprising polyaspirins or poly(N-isopropylacrylamide) that provides for timed local release;
• and
• subjecting the microbubbles to sonic energy to release the effective amount of ReN-1820, ALE-0540 and capsaicin to at least a nucleus pulposus region of a disc, said ReN-1820 provided to disrupt a neuronal element in at least the nucleus pulposus of the disc and a vascular element in at least the nucleus pulposus of the disc,
• wherein the depot comprises a pore forming agent comprising polyethylene glycol (PEG) and an excipient in an amount of from 98% to 99.9% by weight based on a total weight of the depot.

A method for treating back or neck pain with or without radiculopathy wherein the pain is caused by NGF, the method consisting of:

• providing an effective amount of at least one active ingredient configured to disrupt a neuronal element in at least the annulus fibrosus region or the nucleus pulposus region of the disc and a vascular element in at least the annulus fibrosus region or the nucleus pulposus region of the disc, the active ingredient consisting of ReN-1820, ALE-0540 and capsaicin encapsulated in microbubbles comprising a protective coating for timed local release;
• conjugating the at least one active ingredient to a monoclonal antibody to keratan sulfate configured to selectively target a degenerated disc;
• and
• delivering the at least one active ingredient conjugated to the antibody systemically to a patient having back or neck pain via sonic energy such that the microbubbles release the active ingredient.