Back Pain May Be Genetic
September 23, 2012

Bad Back? Better Check Your Genes

April Flowers for — Your Universe Online

Most of us suffer from lower back pain at some point in our lives. Good posture and sitting up straight might help, but depending on your genes, they may not.

A new study, published in the Annals of Rheumatic Diseases, says that your genes, specifically the Park2 gene, play a key role in lumber disc degeneration (LDD). LDD has long been thought to be the number one cause of chronic back pain.

With LDD, the discs in your back, which cushion the vertebrae, become dehydrated and end up being squashed and bulging out over the years while bony growths called osteophytes can emerge from the spinal column. Both situations are thought to cause back pain.

This new study has found that serious LDD is inherited in 65% to 80% of cases.

“The impact of hereditary factors on LDD is remarkably high. In the 70s and 80s the Scandinavians spent millions looking for all the occupations which caused back pain, but they couldn´t find them," said Dr Frances Williams, from the Department of Twin Research and Genetic Epidemiology at King´s College London.

Studies of identical twins that went into disparate professions, such as a truck driver and a PE teacher, showed both ended up with similarly bad lumbar disk degeneration later in life.

Dr. Williams and her team suggest that the main variation is caused by genetic factors. They discovered variants in the Park2 gene by looking for signs of LDD in the back scans of 4,600 people, and then searching their entire genomes for clues.

They believe that this discovery could lead to new treatments, however, the relationship between physical degeneration and chronic back pain is complicated.

Professor Alan Silman, medical director at Arthritis Research UK, said, "Lumbar disc degeneration is a common cause of lower back pain, and it's known that up to 80% of cases have a genetic basis, but this is the first time a gene has been identified as linked to this often painful and disabling condition.

According to Dr. Williams, "Everyone gets LDD at some point, it's like going grey.  But not everyone gets back pain."

"We know that people whose discs wear out are at increased risk of episodes of lower back pain, but normal human discs are hard to get hold of to study so until now our knowledge of normal human biology was incomplete.

"Further work by disc researchers to define the role of the PARK2 gene will, we hope, shed light on one of most important causes of lower back pain."

Even though people with serious physical degeneration are more likely to get chronic back pain, lots of people whose LDD looks really bad actually feel fine.

Dr. Adam Al-Kashi, of the charity Backcare, says that chronic back pain is not merely the result of physical damage. Rather, psychology is also important, and people who had a positive outlook were less likely to suffer.

“We are discovering that pain is an abhorrent response of the central nervous system, which is controlled by the mind,” he said.

Most people, even doctors, assume that chronic pain is permanent — and the best one can do is manage it. However, recent work suggests otherwise.

“We are finding we can reprogram the software - the brain - to overcome chronic pain,” he said.

Dr. Al-Kashi argues that studies that attempt to reduce illnesses to genetics wrongly make people feel helpless, as if there is nothing they can do.

Genetic studies do not reveal the whole picture, Dr. Williams says. People should still take care of their general health to minimize the chance of back pain, especially avoiding smoking and gaining a lot of weight.

She added: "Sitting up straight and exercising won't change the way your discs change, but they might help you develop good muscular strength to keep a pain-free spine and back."

“We have little control over the genes we are born with, but we can manage how we support our backs in other ways, such as exercise. This can prevent an existing condition from getting worse or delay the onset of a hereditary one. The majority of people should be using exercise and a healthy lifestyle to protect their backs against future injury, states Steve Tolan, advisor at the Chartered Society of Physiotherapy.

“To use an analogy, it doesn´t matter what type of car you have, you still need to keep the engine maintained.”