Back pain and disc degeneration: Are they really linked?

Abstract

Back pain or lower back pain (LBP) still remains a controversy, with an apparent lack of understanding of the basic genetic and pathophysiologic mechanisms that predispose patients to this common disabling condition. It has been estimated that LBP affects up to about 80 % of all people during their lifetime (Andersson 1995, 1999). At a given moment, approximately 30 % of the American population suffer from LBP (Frank et al. 1996). LBP thus affects many individuals and is a major societal cost in terms of inability to work, medical treatment, and rehabilitation. In the USA, the total cost was estimated to $50 billion in 1991 (Frymoyer and Cats-Baril 1991) and in Sweden in 1995, with a population of eight million people, to SEK 29.4 billion (approx. US $5 billion) (Nachemson and Jonsson 2000). Low back pain usually has a good prognosis, and most people are able to return to work within a limited period of time, although about 20 % may have recurring problems within 6 months (Cassidy et al. 2005). Also, a considerable number of individuals may suffer from long-lasting low back pain. Because of the lack of knowledge of the underlying causes for back pain and sciatica, it is difficult to define specific treatment modalities.