Search for other papers by Christopher R. Brigham in
Current site
Google Scholar
PubMed
Search for other papers by James B. Talmage in
Current site
Google Scholar
PubMed
Search for other papers by Charles Brooks in
Current site
Google Scholar
PubMed
Search for other papers by Gunnar Andersson in
Current site
Google Scholar
PubMed
Search for other papers by Craig Uejo in
Current site
Google Scholar
PubMed
Abstract
The primary cause of degenerative disc disease (DDD) is nonoccupational factors such as genetics and aging, and attributing DDD to “cumulative trauma” at work is a myth that is not supported by current scientific evidence. Some authors have suggested that DDD is a misnomer because the condition is not a disease but rather an inevitable component of the aging process that occurs at variable rates in different persons. Causation analysis requires a link between a cause and an effect, and reference to “cumulative trauma” without identification of a specific accident is incomplete. Physicians appear sometimes to opine “to a reasonable degree of medical certainty” that certain work events caused or aggravated a condition solely on the basis of a temporal relationship. Further, DDD usually is not the cause of neck or back pain but rather is an incidental finding on x-rays or advanced imaging studies. A dominant view of disc degeneration has been that disc structures are damaged by occasional excessive forces and the cumulative effects of repeated loading—but modern science contradicts this view. The authors examine current publications regarding DDD (including four full abstracts from recent articles) and conclude that current scientific evidence does not support the premise that “cumulative trauma” results in or aggravates degenerative disc disease. “Repetitive strain injury” of the spine is a mythical medicolegal concept, not a clinical or pathologic reality.
-
Bakker EW, Verhagen AP, Trijffel E, et al. Spinal Mechanical Load as a Risk Factor for Low Back Pain. Spine 2009; 34:E281–E293 (PMID: 19365237)
-
Battie, MC, Videman T, Levälahti E, Gill K, Kaprio J. Heritability of low back pain and the role of disc degeneration. Pain. 2007 Oct;131(3):272-80. Epub 2007 Mar 1 (PMID: 17335977)
-
Okada E, Matsumoto M, Ichihara D, et al. Aging of the Cervical Spine in Healthy Volunteers A 10-Year Longitudinal Magnetic Resonance Imaging Study. Spine 2009;34:706–712 (PMID: 19333104)
-
Videman T, Levälahti E, Battié MC. The Effects of Anthropometrics, Lifting Strength, and Physical Activities in Disc Degeneration. Spine 2007; 32 (13): 1406-1413 (PMID: 17545908)
-
1
Melhorn M, Ackerman W. Guides to the Evaluation of Disease and Injury Causation. Chicago, IL: AMA Press; 2008.
-
2
Deyo RA. Imaging idolatry: the uneasy intersection of patient satisfaction, quality of care, and overuse. Arch Intern Med. 2009;169(10):921-922.
-
3
Chou R, Fu R, Carrino JA, et al. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373:463-472.
-
4
Kalichman L, Li L, Kim DH. Facet joint osteoarthritis and low back pain in the community-based population. Spine. 2008;33:2560-2565.
-
5
Okada E, Matsumoto M, Ichihara D, et al. Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study. Spine. 2009;34:706-712.
-
6
Bradford Hill A. The environment and disease: association or causation? Proc R Soc Med. 1965;58:295-300.
-
7
Ward AC. The role of causal criteria in causal inferences: Bradford Hill's “aspects of association.” Epidemiol Perspect Innov. 2009;6:2.
-
8
Burdorf A, Sorock G. Positive and negative evidence of risk factors for back disorders. Scand J Work Environ Health. 1997;23(4):243-256.
-
9
Battié MC, Videman T. Lumbar disk degeneration: epidemiology and genetic influences. Spine. 2004;29(23):2679-2690.
-
10
Battié MC, Videman T, Levalahti E, Gill K, Kaprio J. Heritability of low back pain and the role of disc degeneration. Pain. 2007;131(3):272-280.
-
11
Videman T, Gibbons L, Battié M. Age- and pathology-specific measures of disc degeneration. Spine. 2008;33(25):2781-2788.
-
12
Sambrook PN, MacGregor AJ, Spector TD. Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins. Arthritis Rheum. 1999;42(2):366-372.
-
13
MacGregor AJ, Andrew T, Sambrook PN, Spector TD. Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Rheum. 2004;51(2):160-167.
-
14
Battié MC, Videman T, Kaprio J, et al. The Twin Spine Study: contributions to a changing view of disc herniation. Spine J. 2009;9(1) 49-57.
-
15
Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG. Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in Basic Science. Spine. 2002;27(23):2631-2644.
-
16
Okada E, Matsumoto M, Ichihara D, et al. Aging of the cervical spine in healthy volunteers: a 10 year longitudinal magnetic resonance imaging study. Spine. 2009;34(7):706-712.
-
17
Bakker EW, Verhagen AP, Trijffel E, et al. Spinal mechanical load as a risk factor for low back pain. Spine. 2009;34:E281-E293.
-
18
Waddell G. The Back Pain Revolution. Edinburgh, Scotland: Churchill Livingstone; 2004.
-
19
Videman T, Levälahti E, Battié MC. The effects of anthropometrics, lifting strength, and physical activities in disc degeneration. Spine. 2007;32(13): 1406-1413.
| All Time | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 282 | 282 | 57 |
| Full Text Views | 29 | 29 | 1 |
| PDF Downloads | 0 | 0 | 0 |
