The Mess of Degenerative Changes - Part 6

Blog - The Mess of Degenerative Changes - Part 6

Dr Mary Wyatt | Published: September 18, 2015

This graph is from Professor Charlotte Leboeuf-Yde, who is a sophisticated researcher in this area.

If you are in your 20s, the chance of some degree of degenerative changes is about 10%.  If you are in your 70s the chance is about 70% or 80%.


When someone develops back pain, it is common to see their condition reported as an aggravation of a pre-existing underlying degenerative change.    


But what does this statement mean? 


There is some correlation between back pain and the presence of degenerative changes, but the correlation is weak or poor.  


You are somewhat more likely to experience back problems if you have degenerative changes, particularly if they are more severe. There are however plenty of people who have never had back pain and have terrible looking x-rays. There are also plenty of people who have back pain although their scans appear normal.


The strongest correlation with an experience of back problems is having a previous experience of back complaints.


As referred to earlier, the history in relation to prior back problems is not very reliable. The most likely scenario is that people who have an incident and then have ongoing back pain have had a prior episode of back pain that is either not recalled or not reported. One needs to go back and look at their earlier records.


Scans are of low value in assessing back problems. Numerous reviews, guidelines and advice suggest that they rarely help in terms of identifying treatment, work capacity or future prospects.  


We need to stop relying on scans for work contribution.