Role of lumbar disc degeneration and genetic variation in chronic low back pain

Low back pain (LBP) is a common symptom and leading cause of disability worldwide. The majority of LBP is due to mechanical causes. However, it is challenging to accurately identify a causative factor for chronic LBP and it is considered a multifactorial condition. Lumbar disc degeneration (LDD) is frequently seen in patients with chronic LBP, but radiological features of disc degeneration is poorly correlated with the symptoms of LBP. The role of radiological investigations in chronic LBP is controversial, but it is frequently used in primary care despite the recommendation to use it only on selected patients with serious underlying pathology or progressive neurological symptoms. Pathophysiology of LDD is complex and is mainly genetically determined. Genetic variation may help in classifying varying degrees of LBP in patients with LDD. Improved understanding of the role of radiological features in LDD and genetic investigations help in advancing personalized care and implementing innovative strategies in the management of chronic LBP.