Treatment outcome of chronic low back pain and radiographic lumbar disc degeneration are associated with inflammatory and matrix degrading gene variants: a prospective genetic association study

People with chronic low back pain (LBP) exhibit changes in postural control. Stereotypical muscle activations resulting from external perturbations include anticipatory (APAs) and compensatory (CPAs) postural adjustments. The aim and objective of this study was to determine differences in postural control strategies (peak amplitude, APAs and CPAs) between symptomatic and asymptomatic adults with and without Lumbar Disc Degeneration (LDD) using surface electromyography during forward postural perturbation. Ninety-seven subjects participated in the study (mean age 50 years (SD 12)). 3T MRI was used to acquire T2 weighted images (L1-S1). LDD was determined using Pfirrmann grading. A bespoke translational platform was designed to deliver horizontal perturbations in sagittal and frontal planes. Electromyographic activity was analysed bilaterally from 8 trunk and lower limb muscles during four established APA and CPA epochs. A Kruskal-Wallis H test with Bonferroni correction for multiple comparisons was conducted. Four groups were identified: no LDD no pain (n = 19), LDD no pain (n = 38), LDD pain (n = 35) and no LDD pain (n = 5). There were no significant differences in age or gender between groups. The most significant difference between groups was observed during forward perturbation. In the APA and CPA phases of predictable forward perturbation there were significant differences ankle strategy between groups (p = 0.007–0.008); lateral gastrocnemius and tibialis anterior activity was higher in the LDD pain than the LDD no pain group. There were no significant differences in the unpredictable condition (p>0.05). These findings were different from the remaining groups, where significant differences in hip strategy were observed during both perturbation conditions (p = 0.004–0.006). Symptomatic LDD patients exhibit different electromyographic strategies to asymptomatic LDD controls. Future LBP electromyographic research should benefit from considering assessment of both lower limbs in addition to the spine. This approach could prevent underestimation of postural control deficits and guide targeted rehabilitation.

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The Non-Invasive Investigation of Lumbar Disc Degeneration in Patients with Chronic Low Back Pain.

Australasian Radiology ◽

10.1111/j.1440-1673.1989.tb03281.x ◽

1989 ◽

Vol 33 (3) ◽

pp. 233-236 ◽

Cited By ~ 1

Author(s):

G. BUIRSKI

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Disc Degeneration ◽

Chronic Low Back Pain ◽

Lumbar Disc ◽

Low Back ◽

Lumbar Disc Degeneration ◽

Non Invasive

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Investigating patient expectations and treatment outcome in a chronic low back pain population

Journal of Pain Research ◽

10.2147/jpr.s28636 ◽

2012 ◽

pp. 15 ◽

Cited By ~ 2

Author(s):

Michael E. Robinson ◽

Sanderson ◽

Daniela Roditi ◽

Atchison ◽

Steven George ◽

...

Keyword(s):

Low Back Pain ◽

Treatment Outcome ◽

Back Pain ◽

Chronic Low Back Pain ◽

Patient Expectations ◽

Low Back

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Lumbar disc degeneration and genetic factors are the main risk factors for low back pain in women: the UK Twin Spine Study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2010.137836 ◽

2011 ◽

Vol 70 (10) ◽

pp. 1740-1745 ◽

Cited By ~ 196

Author(s):

Gregory Livshits ◽

Maria Popham ◽

Ida Malkin ◽

Philip N Sambrook ◽

Alex J MacGregor ◽

...

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Disc Degeneration ◽

Genetic Factors ◽

Lumbar Disc ◽

Low Back ◽

Lumbar Disc Degeneration ◽

Sibling Pairs ◽

Validated Questionnaire

ObjectiveLow back pain (LBP) is a common musculoskeletal disorder, but it is still unclear which individuals develop it. The authors examined the contribution of genetic factors, lumbar disc degeneration (LDD) and other risk factors in a female sample of the general population.Material and MethodsA cross-sectional study was conducted among 2256 women (371 and 698 monozygotic and dizygotic twin pairs and 29 sibling pairs and 60 singletons) with a mean age of 50 years (18–84). A self-reported validated questionnaire was used to collect back pain data. Risk factors including body weight, smoking, occupation, physical exercise and MRI assessed LDD were measured. Data analysis included logistic regression and variance decomposition.ResultsThe major factors associated with LBP included genetic background, with OR approximately 6 if the monozygotic co-twin had LBP, or 2.2 if she was a dizygotic co-twin. In addition, LDD and overweight were highly significantly (p<0.001) associated with non-specific LBP. The single most important risk factor was the amount of LDD. After adjustment for other risk factors, the individuals who exhibited advanced LDD (90% vs 10%) had 3.2 higher odds of manifesting LBP. The data also showed a significant (p<0.001) genetic correlation between the LBP and LDD measurements, suggesting that approximately 11–13% of the genetic effects are shared by LDD and LBP.ConclusionsThe main risk factors for reported episodes of severe and disabling LBP in UK women include the degree of LDD as assessed by MRI, being overweight and genetic heritability.

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