What is degenerative disc disease?
It use to be believed (and still is by some!) that the disc is the root cause of persistent low back pain. That our backs through misuse and heavy loading degenerate. Leading to early dehydration and narrowing of the disc space. Then ultimately chronic pain develops as a result of degenerative disc disease. However there is little evidence to support this view.
The Twin Studies
The twin studies are a series of comprehensive articles that looked to investigate this very theory. The aim was to try and ascertain if different environmental factors had an effect on the disc. From smoking and obesity, to job and lifestyle. One of these studies in particular focused on twins that had a complete discord in the type of jobs that they did. So you had one Twin who did more sedentary work and then other more physical. For example a lifetime of office work compared to farm labour.
What they found?
You would think that with a lifetime of doing physical labour that one’s back would be worse than an individual who had been 9 to 5 in an office. However the study found no significant differences in all of the 147 pairs of twins investigated through MRI scanning. Therefore physical work does not seem to wear out our spines, on the contrary it seems to keep them healthy. Many of the findings on an MRI scan such as changes to the disc can all be found in pain free populations. Therefore they are poorly linked to back pain. These changes should really be likened to grey hair – a normal part of aging. Not wear and tear!
So does degenerative disc disease exist?
In word – No! It is not a disease of the spine and it is not caused by wear and tear. In fact lifting and being physically active is healthy for our backs, which are naturally strong structures. All of us get natural age related changes of our backs and bodies but they are not linked to pain.
See also:
- Stress and pain sensitivity
- Benefits of sleep – sleep and pain (Part II)
- The benefits of sleep – emerging evidence (Part I)
- Stress and pain sensitivity
- Low back pain: why we need to pay attention?