Associations between back pain across adulthood and spine shape in early old age in a British birth cohort

Stella G. Muthuri (Corresponding Author), Anastasia Pavlova, Fiona R. Saunders, Rebecca J. Hardy, Jennifer S. Gregory, Rebecca J. Barr, Kathryn R. Martin, Judith E. Adams, Diana Kuh, Richard M. Aspden, Rachel Cooper

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We aimed to examine whether back pain across adulthood was associated with spine shape at age 60-64 years. Data were from 1405 participants in the MRC National Survey of Health and Development, a nationally representative British birth cohort. Back pain was ascertained during nurse interviews at ages 36, 43, 53 and 60-64 years. Cumulative exposure to back pain was then derived by counting the number of ages at which back pain was reported. Statistical shape modelling was used to characterise thoracolumbar spine shape using lateral dual-energy x-ray absorptiometry images which were ascertained at age 60-64 years. Linear regression models were used to test associations of spine shape modes (SM) with: 1) cumulative exposure to back pain; 2) back pain reports during different periods of adulthood. After adjusting for sex, higher cumulative exposure to back pain across adulthood was associated with wedge-shaped L4-5 disc (lower SM4 scores) and smaller disc spaces (higher SM8 scores) in both sexes. In addition, reporting of back pain at ages 53 and/or 60-64 years was associated with smaller L4-5 disc space (lower SM6 scores) in men but not women. These findings suggest that back pain across adulthood may be associated with specific variations in spine shapes in early old age.
Original languageEnglish
Article number16309
JournalScientific Reports
Publication statusPublished - 5 Nov 2018

Bibliographical note

We wish to acknowledge the crucial role of Professor Judith E Adams (deceased 30 September 2017) in undertaking this project. We thank the NSHD study members for their participation in the study and continual support. We also thank Dr Michael Machin for assisting with obtaining the DXA images and the University of Aberdeen Data Management Team for programming support for ‘Shape’ software. The authors are grateful to the NSHD scientific and data collection teams at the following centres: MRC Unit for Lifelong Health and Ageing; Wellcome Trust (WT) Clinical Research Facility (CRF) Manchester; WTCRF and Medical Physics at the Western General Hospital in Edinburgh; WTCRF and Department of Nuclear Medicine at University Hospital Birmingham; WTCRF and the Department of Nuclear Medicine at University College London Hospital; CRF and the Department of Medical Physics at the University Hospital of Wales; CRF and Twin Research Unit at St Thomas’ Hospital London.

The NSHD is funded by the UK Medical Research Council. SGM, RC, RJH and DK are supported by the UK Medical Research Council (Programme codes: MC_UU_12019/1, MC_UU_12019/2 and MC_UU_12019/4). This project was funded by the UK Medical Research Council (Grant MR/L010399/1) which supported SGM, AVP and FRS. The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of this manuscript.


  • bone
  • epidemiology


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