MRI Shows Back Trouble May Begin Before Puberty
Degenerative disc disease-a precursor to low back pain-is a common condition
affecting adults and often attributed to numerous confounding factors, particularly
aging, obesity, lack of activity or proper conditioning, or disease. The hallmark
of degenerative disc disease is lower back pain, one of the most common clinical
complaints in adults. Long considered to be a consequence of aging, a recent
study presented at the Radiological Society of North America (RSNA) annual meeting
in Dec. 2003 has found that disc degeneration may actually have its beginnings
at a fairly young age: in children!
This study evaluated magnetic resonance imaging (MRI) exams of the spines of
154 children in northeastern Scotland. Surprising, investigators found that
14 children (9 percent) had abnormalities in at least one of their intervertebral
discs - the backbone's "shock absorber." MRI was performed on the
10-year-olds as part of a larger study exploring causes of spinal stenosis,
or a narrowing of the spinal canal.
Intervertebral discs are round, spongy pads of cartilage that sit between the
vertebrae, cushioning the backbone as the body moves. With normal aging, the
elastic core of the disc solidifies, contributing to a gradual loss of flexibility
in the back. Fissures and cracks within the discs may also occur, allowing the
gel-filled interior to bulge and extend into the spinal canal, occasionally
irritating the nerve root.
The 14 degenerated discs found by researchers in this study showed signs of
early bulging or tearing. All were located in the lower, or lumbar, region of
the spine. None of the children in the study - 79 girls, 75 boys - had ever
reported lower back or leg pain. Disc degeneration may alter the mechanical
architecture of the back, predisposing to muscle and ligament sprains and strains,
as well as arthritis of the spinal joints. This indicates that disc degeneration
is not necessarily associated with back pain, and may begin in early childhood.
Lower back problems affect millions of adults. In the United Kingdom, 3 million
workdays were lost in 2002 due to lower back pain, according to the National
Health Service. In the United States, back pain is the second most common cause
of lost work, following the common cold, according to the American Academy of
Physical Medicine and Rehabilitation. Americans spend at least $50 billion each
year on lower back pain, according to the National Institute of Neurological
Disorders and Stroke.
Proper back care should include learning about correct
posture and how to stretch the back, as well as being physically active on a
regular basis. Researchers plan to conduct a follow-up study on these same children
in 10 years to help determine whether early disc abnormalities worsen or stay
the same as an individual ages
Created: 1/15/2004  - Donnica Moore, M.D.