Study Suggests Role for Genes in Painful Disc Disorders
By Salynn Boyles
WebMD Health News
Reviewed by Laura J. Martin, MD
Feb. 4, 2011 -- If you suffer from persistent low back pain, your genes may bear some of the blame.
Just like eye color and baldness, the likelihood of developing low back pain from disc disease may be inherited, a new study shows.
When researchers analyzed health and family history data for 2 million Utah residents, they identified 1,264 with a diagnosis of lower spine disease associated with herniated or degenerating discs. Disc disease is one of the most common causes of persistent low back pain.
People with an immediate family member, such as a parent, sibling, or child, with disc-related low back pain were more than four times more likely to have low-back pain themselves.
More modest increases in risk were associated with having a second- or even a third-degree relative with a diagnosis of herniated or degenerative disc disease.
This finding was particularly relevant because these more distant relatives were less likely than first-degree relatives to share the same environmental risk factors for low-back pain.
"While not 100% conclusive, this is very strong evidence that there is a genetic component to disc degeneration and disc herniation," study researcher Alpesh A. Patel, MD, of Salt Lake City's University of Utah School of Medicine, tells WebMD.
Back Pain All in the Family
Just about everyone experiences sporadic back pain at some point in their lives, but most people get better with little treatment after a few days or weeks.
Patel says it is common for complaints of persistent back pain to run in families, but the reasons for this have not been clear.
"Patients with back pain often tell me that their dad or granddad had it too, but it may be that they were in the same line of work or played the same high-impact sports," he says.
Patel and colleagues were able to track low-back-related disease within families thanks to a unique registry known as the Utah Population Database, which contains both health and genealogic information for 2.4 million residents of the state.
One puzzling aspect of disc-related low back disease is that some people with herniated or degenerating discs suffer excruciating pain and other people experience no pain at all.
Pain Perception May Be Driven by Genes
In the University of Utah study, there appeared to be a genetic component to whether disc disease caused symptoms.
"We really can't say from this study if people who are genetically predisposed have more disc problems or if they just experience more pain," Patel says.
A growing body of research suggests that susceptibility to pain is inherited, although no actual pain genes have been identified, he adds.
Back surgeon Daryll C. Dykes, MD, PhD, tells WebMD that he is not surprised by the findings from the Utah study.
Dykes is a spokesman for the American Academy of Orthopaedic Surgeons and a surgeon with the Twin Cities Spine Center in Minneapolis.
"We have had strong suspicions that genes are a factor in low back pain, but we haven't had good scientific studies to back that up," he says.
He says people with a family history of low back pain can lower their risk by maintaining a healthy weight, performing cardiovascular and core strengthening exercises, and not smoking.
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SOURCES: Patel, A. Journal of Bone and Joint Surgery, published online Feb. 2, 2011.Alpesh A. Patel, MD, department of orthopaedics, University of Utah School of Medicine, Salt Lake City.Daryll C. Dykes, MD, PhD, orthopaedic surgeon, Twin Cities Spine Center, Minneapolis; spokesman, American Academy of Orthopaedic Surgeons.News release, American Academy of Orthopaedic Surgeons.
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