• Roxanne van den Berg, Lisa M Jongbloed, Natalia O Kuchuk, Leo D Roorda, Oostveen Johanna C M JCM, Bart W Koes, Oei Edwin H G EHG, Bierma-Zeinstra Sita M A SMA, and Luijsterburg Pim A J PAJ.
• *Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands †Department of Rheumatology, UMC Utrecht, University Medical Center, Utrecht, The Netherlands ‡Amsterdam Rehabilitation Research Center Reade, Amsterdam, The Netherlands §Department of Rheumatology, ZGT Almelo, Almelo, The Netherlands ¶Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
• Spine. 2017 Oct 1; 42 (19): 1464-1471.

Study DesignCross-sectional study, nested in a prospective cohort (Cohort Hip and Knee, CHECK).ObjectiveLow back pain (LBP) is very common and the main cause of activity limitations and work absence throughout the world. Although lumbar disc degeneration (LDD) is suggested as a cause of LBP, this association remains debatable. Therefore, this study assessed the association between the radiographic features of LDD and the presence of self-reported LBP, LBP persisting longer than 3 months, the perceived severity of LBP and presence of neuropathic pain.Summary Of Background DataPrevious literature suggests an association between LBP and both the LDD definitions osteophytes and disc space narrowing. There are no studies that have explored the association between LDD and neuropathic pain.MethodsAssociations between the radiographic LDD using two definitions (i.e., osteophytes, disc space narrowing) versus the presence of LBP, LBP > 3 months, severe LBP and neuropathic pain, were analyzed with logistic regression models.ResultsA total of 699 participants completed the questionnaire and had a lumbar radiograph. Radiographs were scored by two independent observers. Osteophytes were present in 98% of the population and disc space narrowing in 67%. Osteophytes were not significantly associated with LBP (OR = 1.2, 95% CI 0.9-1.7). Disc space narrowing was significantly associated with the presence of LBP and neuropathic pain (OR = 1.7, 95% CI = 1.2-2.4 and OR 1.7, 95% CI 1.1-2.7, respectively). The presence of a LBP severity score of ≥4, and LBP persisting > 3 months were not significantly associated with the two definitions of LDD.ConclusionThis study shows the presence of an association between disc space narrowing, whereas no association was found between osteophytes and LBP. We are the first to report an association between disc space narrowing and neuropathic pain.Level Of Evidence3.

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