EMBARGO DATE: JANUARY 15, 2002
Study Questions Work-Related Risk Factors for Spinal Disc Degeneration
PHILADELPHIA, PA January 15, 2002 - The risk of disc degeneration in the lower back is not necessary related to back pain, nor to the occupational risk factors--such as heavy lifting--traditionally associated with back pain, reports a study in the January issue of the journal Spine.
A Swiss research team led by Dr. Achim Elfering of University of Berne used magnetic resonance imaging (MRI) scans to look for evidence of lumbar (lower back) disc degeneration in 41 adults who were initially free of back pain. Follow-up scans performed five years later showed that disc degeneration had developed or progressed in 41 percent of subjects.
A wide range of possible risk factors for disc degeneration were evaluated, focusing on work- and sports-related factors. Back pain was not a significant factor--patients with disc degeneration were only slightly more likely to develop back pain.
After adjustment for other factors, there were just three significant risk factors: the presence of disc herniation, lack of sports activities, and night shift work.
Surprisingly, none of the "classic" occupational risk factors for low back pain--such as heavy lifting and carrying, twisting, and bending--were significantly related to disc degeneration.
Most previous studies of risk factors for low back pain have focused on patients who already have pain. The new study focused on people who were initially free of back pain and included objective assessments of the discs by MRI scanning.
The results suggest that the work-related risk factors for back pain may not be the same as those for disc degeneration. The researchers write, "the association between progressive disc degeneration and pain cannot be taken for granted."
Some of the risk factors identified, such as night shift work, cannot be readily explained without further study. The risk of disc degeneration is most likely affected by a combination of genetic and environmental factors, Dr. Elfering and colleagues suggest.
Recognized internationally as the leading journal in its field, Spine reports on today's most important diagnostic and therapeutic advances regarding spinal pain, deformity, and disability. Distinguished by its broad scope of coverage and emphasis on patient care, this popular biweekly has earned must-read status in the orthopaedic community. For more information, call 1-800-638-3030 or visit www.spinejournal.com.
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