My name is Frances Williams and I work in Genetic Epidemiology at King's College London.
I'm also a Consultant Rheumatologist,
Guy's and St. Thomas' NHS Foundation Trust,
and I'm delighted to give this talk on
the Genetic Epidemiology of Low Back Pain and Intervertebral Disc Degeneration.
In this talk, I will describe the enormous burden of low back pain worldwide,
will cover its relationship with
intervertebral disc degeneration and the contribution made by twin studies
and large epidemiological studies to understanding
intervertebral disc degeneration in the general population.
I will also touch on the role of
the new techniques available in genetics and Omics studies,
to identify new pathways in pathogenesis.
Low back pain is a huge social problem and is defined as the pain between
the costal margin and inferior gluteal fold lasting more than three months.
Previously considered to be a most burdensome condition in Western societies,
it is now recognized as a worldwide problem.
The Lancet Global Burden of Disease ranked it sixth and it's less than 2010,
having risen from 11th position in 1990.
Of note, it ranks first,
as a cause of disability in Western Europe and Australasia.
Second, in North Africa,
Middle East and Asia Pacific,
and South Latin America.
The overall costs associated with low back pain,
including consultations, investigation, treatment, time off work,
disability benefits are estimated to exceed €15 billion in Europe alone and it
needs to be recognized that Western medicine largely
overlooks the very considerable proportion of low back pain,
which is labeled as mechanical low back pain,
which disc degeneration is usually underlying.
Western medicine being very much geared to identifying rarer causes of low back pain,
such as tumor and inflammatory spine disease.