Deconditioning in chronic low back pain: might there be a relationship between fitness and magnetic resonance imaging findings?
The presence of persistent low back pain leads to avoidance of daily activities, contributes to further exercise intolerance and subsequent further loss of functional capacity. We sought to search for the relationship between lumbar magnetic resonance imaging findings and deconditioning in a homogeneous subset of patients with low back pain. We studied 20 sedentary, nonsmoking patients with chronic low back pain using symptom-limited cardiopulmonary exercise testing using treadmill breath-by-breath analysis using modified Bruce protocol. Lumbar facet and disc degeneration involving L1-S1 levels were assessed using 1.5 Tesla MRI. The total number of levels involved was positively correlated with age (r = 0.478, P = 0.033). The Pfirrmann grading of lumbar disc degeneration was positively correlated with Weishaupt grading of facet degeneration (r = 0.502, P = 0.024); however, VO(2) peak was only negatively correlated with facet degeneration (r = -0.5, P = 0.025). Facet joint-mediated pain is a significant problem in all patients suffering from chronic low back pain. Since in this study, aerobic fitness level was negatively correlated with facet degeneration, we suggest that degeneration of facet joints might better reflect the chronicity of low back pain when compared to intervertebral disc degeneration.
Atalay
Ayce
A
Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Acibadem University, Dereboyu caddesi Ihlamur sokak Uphill Court Residence A1 Blok A40, 34746 Ataşehir, Istanbul, Turkey. ayce.atalay@acibadem.edu.tr
Turhan
Nur
N
Atalay
Basar
B
D000328:Adult; D018493:Cardiovascular Deconditioning / Q000502:physiology*; D002908:Chronic Disease; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000503:physiopathology; D017116:Low Back Pain / Q000473:pathology / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness / Q000502:physiology*; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology*; D057185:Sedentary Behavior