A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women. II. Radiographic findings

Article Abstract:

Back pain is one of the most frequent causes of activity limitation. It is often difficult to determine the underlying problem during the first occurrence of back pain, and X-rays are usually not requested unless back pain persists for at least three months. However, X-rays are useful only if standards marking the natural course of spinal changes in the general population are established. No long-term studies of changes in the lumbar spine (lower back) visible by X-ray have previously been done. To determine whether osteophytes (bone spurs), degeneration of intervertebral discs (shock-absorbing discs present spinal bones), fractures related to osteoporosis (loss of bone density), or other changes visible by X-ray were associated with the development of back pain, results from a long-term medical survey were analyzed. The study included 236 women who had recurrent back pain at the start of the study and 241 women who had never had back pain when the study started. At the start of the study, almost half of women had abnormally small intervertebral spaces, indicative of disc degeneration, and this was more common in those with back pain. Women with back symptoms tended to have more discs affected. Osteophytes were equally common in symptomatic and asymptomatic women. Women with back pain tended less often to have osteoporosis. After 10 years of the study, 64 percent of women had degenerated discs, and this was still more common among women with back pain. More disc spaces were involved, and the number of women with osteophytes was almost 100 percent. The incidence of osteoporosis also increased and remained more common among those without back pain. Development of newly occurring disc degeneration was significantly related to obesity, while having a higher number of children was protective against degeneration. Further deterioration of existing degenerated discs was related to number of discs already involved, and was inversely correlated with age. The study suggests that disc degeneration may explain back pain in some middle-aged women, that osteoporosis is not related to disc degeneration, and that once established disc degeneration progresses in an independent fashion. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Spine

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A longitudinal study of back pain and radiological changes in the lumbar spines of middle aged women. I. Clinical findings

Article Abstract:

Back pain is one of the most frequent physical reasons people must limit their activities. Risk factors associated with the development of back pain include smoking, driving, and repetitive lifting. However, the actual causes of back pain and the natural course of the disorder are not well established, and it is difficult to predict which individuals may develop the problem. Data from a long-term health study were analyzed to improve understanding of these issues. Results from 241 women who had never had back pain and 236 women who reported both current and past back pain were used for this report. Although smoking and oral contraceptive use were associated with back pain at the start of the study, these factors did not remain significant during analysis of subjects 10 years later. Individuals who reported back pain at the start of the study were likely to have a past history of cystitis (urinary tract infection) and a current history of headaches. Body leanness and obesity were not related to back pain. Subjects who had reported recurrent back pain at the start of the study were most likely to report back pain 10 years later. Analysis indicated that pain in hip or knee on standing was the single independent predictor of continuing back pain. Few of the women with or without pain had worked outside the home so occupational factors were not analyzed. X-ray examinations were not helpful in determining subjects who were likely to have back pain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors

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A genetic association study of the IGF-1 gene and radiological osteoarthritis in a population-based cohort study (the Rotterdam study)

Article Abstract:

Variants of the gene coding for insulin-like growth factor 1 (IGF-1) may be associated with the development and progression of osteoarthritis, a destructive joint disease characterized by bony overgrowth and cartilage degradation. IGF-1 stimulates cartilage cell remodeling. Researchers genetically analyzed 786 elderly patients, and found that the IGF-1 gene was clearly associated with osteoarthritis diagnosed by x-ray.

Genetic aspects, Osteoarthritis, Insulin-like growth factor 1, Insulin-like growth factor I

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