For this month’s column I wanted to do something a little bit different. Each month so far I have endeavoured to cover a different topic on back pain. However, this month I am going to go deeper on the topic that I discussed in March’s column.
In particular, this month I am going to be discussing one particular piece of research. This research paper should be considered as one of the highest graded studies on intervertebral disc degeneration and forms a large part of the basis of the information that I give to my patients.
The study in question is by Battié et al and was published in 2009. The reason that this study is so important is because they examined identical twins. Examining differences between identical twins is so significant because any difference between two people who are genetically identical can largely be explained by differing environmental factors, such as their jobs, smoking, diet, exercise habits etc.
For example, in the case of this study, if one twin has a highly physically demanding job and the other twin does not. Then it is possible that any differences in the level of disc degeneration found could be explained by the type of work that they do.
To recap on last month’s column; disc degeneration can largely be defined as the narrowing of the intervertebral discs in our spines and it can happen in both people with and without pain. However, it does seem to happen more commonly in people with back pain.
The traditional model that Doctors and healthcare providers have always told us is that disc degeneration is a product of ‘wear and tear’. For a very long time now patients have been told that disc degeneration is bad, that it is an example of us wearing our spines out and that it must be avoided at all costs.
Some therapists even go one step further as to suggest that the treatment they provide can help to prevent further degenerative changes to the discs (for which there is absolutely no evidence).
What the authors of the study in question found was quite the opposite to the traditional advice we’ve all heard. In fact, they found that there is a substantial influence of genetic factors on intervertebral disc degeneration. They also found that there was very little effect on disc degeneration from occupational or leisure time activities.
This means that they found your own genes are the main reason for intervertebral disc degeneration and NOT regular use of your spine.
I have already had so many patients this year tell me that a Doctor has told them to try and use their spines less when bending and to do less physically demanding work because they are ‘wearing their spines out’. When we compare that advice to the high quality study I am discussing, we can say that this advice simply doesn’t hold water.
I’m not saying to go out and go mad lifting things that are way too heavy for you (that’s not a good idea) – you can still injure yourself! But regular, sensible use of your spine is unlikely to have any adverse effects on your intervertebral discs.
This isn’t to say that certain activities wont lead to back pain. We know that people with physically demanding job are in one of the highest risk categories for developing low back pain. But doing a physically demanding job wont necessarily lead your spine to degenerate at a faster rate.
This article first appeared in the Diss Express.
