Back pain doesn’t follow the signs
This just in: a huge new study of the relationship between low back pain and common signs of spinal arthritis, finding mostly that … there wasn’t much of one. The correlation was there, it was just rather puny. MRI findings, on average, “do not have clinically important associations with low back pain.”
The study was a bit unusual and quite useful because it was a big “longitudinal” one: observing the same group of people for a long time. We don’t see a lot of those in back pain research, especially of this size/duration: about 3300 people studied for over six years. That design gives us insight into the order of things, producing what I think is the most important single result here: pain didn’t develop in people who started out with signs of spinal degeneration. It’s not just that signs and pain aren’t strongly correlated, it’s that pain doesn’t follow the signs. More formally stated by the authors:
“We found most MRI findings were not associated with future LBP-severity regardless of the presence or absence of baseline pain.”
And the signs don’t follow the pain either!
Another way to sum this study up: most spinal arthritis isn’t painful, which sounds a bit radical. But none of this is actually news. It’s just excellent new data that really drives the old point home that most back pain is not really about spines being all cruddy with arthritis.
Great addition to the salamander's bibliography.