Degenerative physiochemical events in the pathological intervertebral disc.

ABSTRACT

Low back pain is one of the commonest musculoskeletal complaints that affects individuals of all ages and is a leading contributor towards work loss worldwide. The range of current treatment modalities involving surgeries, injectable agents, and medications is promising but cannot address the reasons behind the occurrence of pain in patients with degenerative disc pathologies. One possible factor for the limited success is the lack of evidence behind the identification of early, intermediate, and late stages of painful changes methodologically in a vast group of populations and the manifestation of the diseases in terms of increased physical activity, hereditary patterns, and various risk factors. However, despite these challenges, steady progress has been achieved in understanding the parameters in abnormally loaded progressively degenerating discs and these features have been elucidated at a physical, biochemical, and cellular level. These recent findings can likely lead to the development of therapeutic interventions that will identify and retard tissue damage, decrease pain, and improve the quality of life in these patients. Therefore, the main aim of this review is to integrate recent updates in intervertebral disc degeneration research for the development of evidence-based screening protocols and more targeted interventions in the management of low back pain.