Early Disc Degeneration Leads to Back Pain
Disc disease accompanying low back pain is a key issue in research and clinical practice, particularly in terms of how this potential association impacts the pediatric population. Recent surveys among children and teens have shown as many as 50% report a history of low back pain (LBP).
A nine-year follow-up survey of 15-18 year olds evaluated the persistence of reported, recurrent LBP, with particular attention paid to the presence of abnormal MRI findings.
In 1,503 children with recurrent low back pain, 40 were chosen randomly and examined by MRI at 15 and 18 years of age. A control group of 40 asymptomatic children were also examined for comparative purposes, and questionnaires administered to both groups at 14, 18 and 23 years of age assessed the recurrence/persistence of LBP.
MRI findings at age 15 were significantly predictive of low back pain at that age and as they got older. Specifically, 35 percent of the participants who reported LBP at age 15 still reported continuous or recurrent pain at 18 and 23 years of age. Additionally, almost all (89%) of the subjects who reported pain at all three ages showed incipient or total disc degeneration at age 15, compared with only 21% of subjects with only one or two LBP reports and 26% of subjects without recurrent LBP.
These findings suggest that disc degeneration at 15 years of age exposes children to a significant risk of persistent, recurrent low back pain. Disc protrusions and changes like those of Scheurmann's disease contributed to the risk of persistently recurrent LBP. The authors state that "the role of the disc in the production of low back pain may be related to exaggerated movement of the motion segment."
Salminen JJ, Erkintalo MO, Pentti J, et al. Recurrent low back pain and early disc degeneration in the young. Spine
, July 1, 1999:24(13), pp1316-21.