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Why don't all people with wear and tear in their lower back have pain?

Award Details

  • Principal Investigator
    Dr Janet Deane
  • Type of grant
    ZZZ-Nurse and Allied Health Professional Training Fellowship
  • Amount Awarded
  • Institute
    Imperial College London
  • Location
  • Status
  • Start Date
  • Grant reference number
  • Condition
    IVD degeneration, Spondylosis

What are the aims of this research?

Over 90% of older people have wear and tear in their lower spine, but not all of them experience back pain. This research study will investigate why some people with wear and tear in their lower spine have a lot of pain whilst others have little or no pain, by examining how people with and without low back pain move and function looking at not only how their back moves but also their hips and legs.

Why is this research important?

90% of people over the age of 64 years have wear and tear in their lower spine, but only around 60% of people over 60 years experience low back pain and there is currently no explanation for why this is the case. Unlike most previous research which has studied the spine in isolation, this study will look at how the spine moves in conjunction with the hip and legs. This approach could provide extra information to explain the differences in pain, for example it may be that the hips and legs are able to compensate for degeneration or move differently so that stress is removed from the spine, eliminating pain.  

This research project will study people with and without lower back pain. Imaging techniques will be used to investigate the amount of spinal degeneration that each individual has and how their bodies move, particularly their back and lower limbs, during a series of everyday movement and balance tasks. This information will be used to determine whether people with spinal degenerative changes move and stand differently, and whether the muscles are stronger and healthier in people who experience no pain but have signs of spinal degeneration. While the main focus of this study will be on physical characteristics such as patterns of movement and muscle activity, other factors which may also impact a patient’s ability to manage their low back pain including disability, coping and anxiety will also be considered.

How will the findings benefit patients?

If hip and leg movement is shown to be related to patient experiences of lower back pain this could inform future patient care, for example patients could be encouraged to adapt and move differently so that they are able to do more with less pain. This will help physiotherapists to deliver the right care to patients in the right way, making physiotherapy more effective, reducing costs to the NHS and leading to improved outcomes and quality of life for patients.


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