A study examining the purported link between lower back pain (LBP) and lumbar disc degeneration (LDD) determined evidence of an association between LBP and hip or knee osteoarthritis. A review of several published observational studies was unable to establish an association between LBP and osteophytes, though a moderate association between LBP (particularly neuropathic pain) and disc space narrowing was noted.
Researchers used logistic regression models to analyze associations between radiographic features of LDD and neuropathic pain in a total of 699 study participants who completed a questionnaire and lumbar radiograph. The radiographs were analyzed by two independent observers, who found that the presence of osteophytes in 98 percent of the population was not associated in any significant way with LBP.
Disc space narrowing, however, which occurred in 67 percent of the study participants, was significantly associated with neuropathic and LBP.
The results of the 8-year follow-up, cross-sectional study in the Cohort Hip and Knee (CHECK) cohort in the Netherlands found that radiographs of the lumbar spine in patients with hip and knee osteoarthritis demonstrated a strong association between LDD and disc space narrowing, with LBP (particularly neuropathic) but little association between osteophytes and LBP. However, LBP was frequently reported in patients with osteoarthritis of the hip and knee.
Though there appears to be no overt association between the presence of osteophytes in radiographs and LBP, a link is evident between disc narrowing/ degeneration and LBP. Furthermore, the presence of LBP in a great percentage of hip and knee osteoarthritis patients in cross-sectional study indicates a possible link between the conditions. The results of this study indicate the need for further research into the possible link between osteoarthritis of the hip and knee and LBP/LDD.