Generations of Degeneration: Hereditary Components of Disc Disease

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If you’ve ever wondered how many degenerates are in your family tree, there are medical researchers who can probably tell you. However, they may be looking at very different characters than you imagined.

The American Academy of Orthopaedic Surgeons submitted an article to the Journal of Bone and Joint Surgery claiming a strong inherited predisposition to lumbar disc disease, a degeneration or herniation of the discs of the lower spine.

What is Disc Degeneration?

The vertebrae in your spine are cushioned by soft disks that absorb shock, enabling you to flex, twist and bend, says the University of Utah Health Care Spine Services web page. Due to age or heredity, some of the diseases that cause degeneration of these discs include:

  • Osteoarthritis
  • Herniated disc
  • Spinal stenosis

Degeneration of the intervertebral discs is what creates many of your spinal problems, according to the University of Maryland Medical Center in the article “A Patient’s Guide to Degenerative Disc Disease”:

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Everything you do during the day — once you stand upright — begins to test the spine’s ability to support your body weight. Over time, these repeated daily stresses and minor injuries can add up and begin to affect the discs in your spine. Minor injuries to the disc may occur and not cause pain at the time of the injury.

The discs between vertebrae are designed to absorb pressure because bones are not able to sustain the stress caused by movement without becoming damaged. The article explains that the center of each disc carries water, which acts as an absorber. The outer ring has a tough ligament material called the annulus, which holds the vertebrae together and is usually the first location of injury. Small tears in the ligament material create scar tissue, which is not as strong as normal ligament tissue. Eventually, the nucleus begins to lose its water content due to the damage and is less able to act as a cushion. It collapses and moves vertebrae closer to each other, and joints located at the back of the spine are forced to shift.

Treating Pain

The most common early symptom of degenerative disc disease is usually pain in the back that spreads to the buttocks and upper thighs, says the Maryland article. Discogenic pain is similar to a broken bone or cut in the skin — when your body is inert you don’t experience pain, but when you begin movement, the pain returns.

A spine evaluation from a chiropractor can help you determine the best treatment plan for your condition. Using spinal manipulation, a medical professional can assess the extent of the disc degeneration and construct an individualized treatment plan for you.

You can expect a medical professional to suggest modifications of your lifestyle to minimize pressure on the discs involved. Regular chiropractic care can enable you to further manage the degeneration of your spine, and thus avoid surgery and the need for excessive medication for successful treatment, if possible.

Whether you choose a conservative treatment plan or a more aggressive course of action, you should count on a medical professional to track any changes in your condition. Your chiropractor can advise you regarding the seriousness of your condition and help you maintain as normal a routine as possible.

Causes

Discs that fail first are those under the most mechanical stress, which are usually in the lower lumbar region, according to the Journal of the Radiological Society of North America. In the article “Lumbar Degenerative Disk Disease,” researchers are unclear whether causes begin with inherent medical condition or force from the outside.

“[Disc] degeneration involves structural disruption and cell mediated changes in composition, but which occurs first is not clear,” the article says. “Biochemical factors can increase susceptibility to mechanical disruption, and this could adversely influence disk cell metabolism.”

The RSNA article cites studies showing the genetic predisposition to disk disease.

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In a study of 115 male identical twin pairs, the effects of lifetime exposure to commonly suspected risk factors on disk degeneration, including job type, lifting, twisting, sitting, driving, exercise, drama, and cigarette smoking, were investigated. The particular environmental factors studied, which have been among those most widely suspected of accelerating [disc] degeneration, had only modest effects.

Their conclusion was that disc degeneration is mostly influenced by genes.

The University of Utah conducted studies of twin siblings and found a genetic predisposition for the development of lumbar disc disease, but the research included a small number of patients. So, more recently, Alpesh A. Patel, MD FACS, assistant professor of orthopedic surgery at the University of Utah School of Medicine, conducted a new, larger study.

“The results of this study provide evidence based on a population of more than 2 million people, indicating that there likely is a genetic component in the development of this disease,” Dr. Patel said.

Researchers used data in the Utah Population Database, which contains health and genealogic data of more than 2 million Utah residents. The data included 1,264 individuals with lumbar disc disease, including only patients who had at least three generations of data available.

The Utah study incorporated information from:

  • First-degree relatives (immediate family)
  • Second-degree relatives (grandchildren, aunts, nieces, etc.)
  • Third-degree relatives (great-grandchildren, great-aunts, grandnieces, etc.)

The researchers found that relative risk of lumbar disc disease occurred in both immediate family and in more distant relations, which was key.

“Although excess risk in the immediate family might indicate evidence of a genetic contribution, it could also simply indicate shared environment risks or household exposure that may be contributing to the disease,” Dr. Patel said. “Conversely, excess risks in second- and third-degree relatives strongly support a genetic contribution to disease, given the measurable genetic sharing in these more distant relatives and the relative absence of shared household risks.”

If you’re suffering from lower back pain due to disc degeneration, the good news is you can seek treatment to slow its effects. And in more good news … you may be able to blame your parents.

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