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Association Exists Between Lumbar Disc Degeneration and Low Back Pain

It is very likely that everyone knows someone who has experienced back pain, if they haven't experienced it themselves. In the Netherlands, it's estimated that almost 27 percent of adults have had or do have back pain and one school of thought believes that lumbar disc degeneration is a possible risk factor for lower back pain in adults. Lumbar disc degeneration is the wear and tear of the discs in the lower back, the lumbar region.

X-rays of the lumbar region can show if there is disc degeneration and one research team, led by Lane, developed a grading system that would tell how much degeneration was present, as seen by the x-ray. The authors of this article wanted to see if they could use the rating system, along with patients' reports of lower back pain, to see if the rating system could tell ahead of time if there would be pain. In other words, could the rating system determine if someone was at risk for back pain.

Researchers obtained 2,819 lumbar x-rays of patients who were over 55 years old; 1,615 of the patients were women. A trained radiologist reviewed the x-rays, looking for disc degeneration. The x-rays were rated as:

- 0 meant no degeneration was seen
- 1 meant there was mild degeneration
- 2 showed moderate degeneration
- 3 showed severe degeneration

Repeat x-rays were done on the patients as they visited the center where they underwent a physical exam, including height and weight, body mass index, bone density, and disability. The disability was assessed using the Stanford Health Assessment Questionnaire, or SHAQ. The patients were also visited at home where the researchers determined their level of back pain. The patients were asked, "Did you have any complaints of the low back during the last month?" They were also asked, "What is the duration of the present low back pain complaints?"

When the results were tabulated, the researchers found that lower back pain was reported more often in women (326) than in men (173), and chronic lower back pain was reported in 84 percent of patients who had lower back pain at that time - again more often in women (95 percent) than men (91 percent). When looking at the x-ray reports, the most common finding among the patients with lower back pain was the presence of osteophytes, or bone spurs. More women than men had narrowing between the discs, although both the osteophytes and narrowing increased with age in both sexes.

The authors concluded that the different findings on the x-rays could be associated with lower back pain, particularly if there were two or more disc levels that were narrowed.

References: Evelien I.T. de Schepper, MD, et al. The Association Between Lumbar Disc Degeneration and Low Back Pain. In Spine. March 1, 2010. Vol. 35. No. 5. Pp. 531-536.

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