All analyses were adjusted intended for age and sex. were differently associated, and back pain was much less explained than leg pain in the multivariate analyses (15 % AZD9898 vs . 31 % of the variation). Back pain intensity was higher in patients with type 1 Modic changes and in some patients with nerve root touch, but was not associated with disc herniations. Leg pain intensity was well explained by disc herniations causing MRI nerve root bargain and radiculopathy. In patients with radiculopathy, nerve root touch caused as much leg pain because nerve root displacement or compression. High intensity zones and osteophytes were not associated with back pain, but only associated with leg pain in patients with radiculopathy. Soft points explained some of the back pain, and widespread pain explained leg pain in some from the patients without radiculopathy. == Conclusions == Back pain was associated with type 1 Modic changes, nerve root touch and soft points, whereas leg pain was associated with osteophytes, HIZ, disc herniation, all sorts of MRI AZD9898 nerve root compromise, radiculopathy and widespread pain. Keywords: Low back pain, Leg pain, Magnetic resonance imaging, Disc herniation, Radiculopathy, Nerve root touch, High intensity zone, Osteophytes, Soft points, Widespread pain == Background == Cross-sectional populace studies have shown statistically significant associations between degenerative manifestations on lumbar magnetic resonance imaging (MRI) and low back pain (LBP) the preceding 12 months [1, 2]. However , degenerative changes occur frequently in persons without LBP [3]. A systematic review including 45 papers discovered weak organizations between LBP and degenerative manifestations with meta-estimates of Odds Ratios ranging from 2 . 3 to 3. 6. [4]. Disc degeneration and disc herniation were recognized in 54 % (476 %) and 27 % (785 %) of persons without LBP, respectively. However , nerve root displacement or compression was only seen in 25 % of those without LBP [4], a finding that has been verified elsewhere [3]. End plate oedema (Modic changes) was not included in the analyses. The difficulties in demonstrating clear-cut organizations between MRI findings and low back pain may have various explanations: First, MRI cannot differentiate between new and old findings, which may weaken a given relationship. Second, many studies only consider the presence or absence of degenerative MRI findings which may be inadequate, as more levels of the lumbar spine involved in one person do not count more than one level in another person. A sum rating may change for this shortcoming [5], but it does not distinguish between persons with many moderate AZD9898 changes and persons with few severe changes, who may have equal sum scores. A rank-ordered classification by the most severely degenerated segment [6] may solve this problem, but then less severely degenerated discs in a person do not count number at all. Finally, back pain may be caused by other mechanisms not necessarily associated with degenerative manifestations. Back pain is part of the definition in chronic widespread pain and fibromyalgia, a subset of this category [7]. The pain in these patients have been shown to be caused by facilitation of pain digesting and/or insufficient pain inhibition due to central neuronal mechanisms [8]. We AZD9898 have previously shown that this type of pain mechanism may play a role in FRAP2 a proportion of patients with non-specific LBP [9]. Furthermore, MRI findings have been associated most clearly with radiating pain below the knee [10], but many studies do not differentiate between back pain and leg pain [1113]. In the present study including a subset from the patients mentioned above [9], both back pain and leg pain intensity were recorded. All patients had LBP with or without radiating pain [14]. Therefore , a comparison between participants with and without pain was not possibly. Instead, we.
