A familial predisposition toward lumbar disc injury

Study Design. A retrospective case-control study was performed. Objectives. To test the hypothesis that there is a familial predisposition to lumbar disc pain and injury. Summary of Background Data. The few studies that have addressed this question have suggested that a familial predisposition is present, but the techniques used for identifying discogenic pain and accounting for potentially confounding extrinsic factors make it difficult to formulate a clear conclusion. Methods. Immediate relatives of index patients who had surgically proven lumbar disc herniations (disc/case subjects) or repetitive upper extremity overuse syndromes (upper extremity/control subjects) were given a questionnaire that had been tested previously and found to reliably identify discogenic lower back pain. The prevalence of lumbar disc pain and injury was determined in the two groups of patients; logistic regression was used to control for demographic factors and activities known to increase risk for lumbar disc injury. Results. The questionnaire was returned by 60 (59%) of 102 disc subjects and 41 (50%) of 81 upper extremity subjects. Sixteen (28%) disc subjects and one (2%) of the upper extremity subjects met questionnaire criteria for discogenic lumbar pain; seven (12%) disc subjects and no upper extremity subjects had received surgical therapy for lumbar disc pain. Logistic regression analysis identified familiar grouping and a history of lifting as the only variables associated with a positive response on the questionnaire. Information obtained from index patients patients about their nonresponding relatives' history of significant back pain suggested similar findings. Conclusions. There is a familial predisposition toward lumbar disc pain and injury. This information may be helpful in occupational counseling or for targeting specific populations with preventative, interventional strategies.