EBQ:SPACE Trial
Krebs et al.. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial. JAMA 2018. 319:872-882. PMID: 29509867. DOI. Full Text.
Clinical Question
What is the contribution of genetics to disc degeneration?
Bottom Line
There is a substantial influence of heredity on lumbar disc degeneration. There is little effect on disc degeneration from occupational and leisure-time physical loading, and increased loading may have a small benefit. There is only a small effect from smoking. Body weight and muscle strength have modest effects on disc degeneration. Some candidate genes were identified.
Study Design
The Twin Spine Study, which started in 1991, is a multidisciplinary, multinational research project with collaborators primarily in Canada, Finland, and the United States. They investigated occupational exposures, driving and whole-body vibration exposure, smoking exposure, anthropomorphic factors, heritability, and the identification of genotypes associated with disc degeneration.