Long-lasting low back pain and MRI changes in the intervertebral discs]

Although low back pain is usually temporary, some patients do not recover and need treatment. Therefore, it is important to uncover causal and contributing factors. Here we give an overview of recent research on MRI findings and genetic factors that may be important for development of long-lasting low back pain.A non-systematic search in PubMed and EMBASE was performed. The relevant research articles identified, as well as the authors' knowledge of the field formed the basis for this review.It is generally accepted that low back pain often stems from intervertebral discs, facet joints and lumbar multifundi muscles. However, it is also known that many patients with pronounced disc degeneration have so-called Modic changes, i.e. MRI changes in bone marrow close to the vertebral endplates. Several recent studies have shown an association between such changes and pain. It has also been demonstrated that patients with Modic changes and low back pain often have concomitant inflammation and growth of nociceptive nerve fibers into the endplates. To which extent this occurs, may be partly based on genetics.Genetic factors may contribute to low back pain. New knowledge about genetic factors and Modic changes can create a basis for better diagnostics and more specific treatment of patients with long-lasting low back pain.