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    Backaches May Be in Your Genes


    Her research group is already hard at work on a gene therapy for lumbar disk disease, which she says should be available in less than 10 years.

    "We're excited about this discovery," says Robert S. Biscup, MS, DO, an orthopaedic surgeon and director of regional spine development at The Cleveland Clinic. "This research is trying to find the trigger mechanism by which the disk starts [to degenerate]. If we can find it and stop or reverse it, it may eliminate the need for these surgeries."

    But if unrelenting back pain is already part of your life, what can you do right now?

    Tremendous progress has been made in the last 15 years in understanding "how the spine works from a mechanical standpoint, how the muscles and joints work -- as well as understanding the mechanisms of pain, what seems to cause back pain," Biscup tells WebMD.

    The spine is complicated because the muscles, bones, ligaments, spinal cord, and nerves all are a very intimate part of the anatomy in that area, explains Biscup.

    "Degenerative spine disease is responsible mostly for back pain, and that in itself can be quite incapacitating. But when the nerves become involved, then patients experience severe leg pain, leg numbness, severe weakness ... and there can be combined problems, ... tremendous back pain because of spinal degeneration and nerve pain because of pinched nerves."

    The two most commonly treated conditions that cause back pain are herniated disk and spinal stenosis, which occurs when the lower end of the spinal column becomes narrowed and compressed, squeezing the spinal cord or spinal nerves.

    In the past, these conditions were treated with aggressive, major surgeries, requiring large incisions to expose the back side of the spine and remove a considerable amount of the spine's bony covering as well as muscle ligaments -- a procedure called a laminectomy.

    Although laminectomy takes pressure off the nerves and relieves the severe leg pain and symptoms, says Biscup, "the spinal degeneration that caused the condition in the first place is still there and continues to progress to some degree. [Surgery] doesn't solve the problem, but treats fairly severe symptoms of the underlying spinal degeneration problem."

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