Abstract
Low back pain (LBP) is the world’s leading debilitating condition [1]. It is estimated that 80% of the general population in the United States will develop LBP at one point in time [2,3]. Such pain can lead to diminished daily function and quality of life and work disability [4,5]. Not surprisingly, spine surgery to address LBP is one of the top five surgeries performed in the United States [6] where approximately 90-billion US dollars in health-care expenses are used annually to treat LBP [7]. As data indicate, LBP is clearly related with detrimental socioeconomic and health-care consequences that motivate efforts to identify LPB risk factors to develop improved prevention and treatment strategies. Although the etiology of LBP is multifaceted, disc degeneration (DD) has been suggested to be one of the most prominent risk factors [8–11]. However, whether DD is synonymous with LBP continues to be a topic of immense controversy. In this article, we review the current data regarding pain generating pathways and epidemiological evidence associating DD with LBP. In further support of this association, we review novel disc imaging techniques that may increase LBP diagnostic sensitivity and specificity. Finally, we discuss relevant aspects of the field of pain genes that may shed further light as to the links between DD and pain.
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