Can specific loading through exercise impart healing or regeneration of the intervertebral disc?

James Steele, Stewart Bruce-Low, Dave Smith, Neil Osborne, Arvid Thorkeldsen

Research output: Contribution to journalArticle

Abstract

BACKGROUND CONTEXT:
Low back pain (LBP) is highly prevalent and presents an enormous cost both through direct health care and indirectly through significant work and production loss. Low back pain is acknowledged widely to be a multifactorial pathology with a variety of symptoms, dysfunctions, and a number of possible sources of pain. One source that has been suspected and evidenced for some time is the intervertebral disc. Some degree of disc degeneration is a physiologic process associated with aging, however, more severe degeneration and/or structural abnormality may be indicative of a pathologic process or injury and is more commonly present in those suffering from LBP. Much like other tissues (ie, muscle, bone, etc.), it has been suspected that there exists an optimal loading strategy to promote the health of the disc. Exercise is often prescribed for LBP and effectively reduces pain and disability. However, whether specific loading through exercise might plausibly heal or regenerate the intervertebral discs is unknown.
PURPOSE:
To examine the effects of loading on regenerative processes in the intervertebral disc and consider the potential for specific exercise to apply loading to the lumbar spine to produce these effects.
STUDY DESIGN:
A brief narrative literature review.
METHODS:
Studies examining the effects of loading on the intervertebral discs were reviewed to examine the plausibility of using loading through exercise to induce regeneration or healing of the intervertebral disc.
RESULTS:
Research from animal model studies suggests the existence of a dose-response relationship between loading and regenerative processes. Although high loading at high volumes and frequencies might accelerate degeneration or produce disc injury, high loading, yet of low volume and at low frequency appears to induce potentially regenerative mechanisms, including improvements in disc proteoglycan content, matrix gene expression, rate of cell apoptosis, and improved fluid flow and solute transport.
CONCLUSIONS:
Research suggests a dose-response relationship between loading and disc regenerative processes and that the loading pattern typically used in the lumbar extension resistance exercise interventions (high load, low volume, and low frequency) might impart healing or regeneration of the intervertebral discs. Future research should examine an exercise intervention with in vivo measurement of changes in disc condition. This may provide further evidence for the "black box" of treatment mechanisms associated with exercise interventions.
Original languageEnglish
Pages (from-to)2117-2121
JournalSpine Journal
Publication statusPublished - 2015

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Intervertebral Disc
Regeneration
Low Back Pain
Intervertebral Disc Degeneration
Pain
Wounds and Injuries
Proteoglycans
Pathologic Processes
Research
Spine
Animal Models
Apoptosis
Pathology
Delivery of Health Care
Gene Expression
Costs and Cost Analysis
Bone and Bones
Muscles
Health

Cite this

Steele, J., Bruce-Low, S., Smith, D., Osborne, N., & Thorkeldsen, A. (2015). Can specific loading through exercise impart healing or regeneration of the intervertebral disc? Spine Journal, 2117-2121.
Steele, James ; Bruce-Low, Stewart ; Smith, Dave ; Osborne, Neil ; Thorkeldsen, Arvid . / Can specific loading through exercise impart healing or regeneration of the intervertebral disc?. In: Spine Journal. 2015 ; pp. 2117-2121.
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Steele, J, Bruce-Low, S, Smith, D, Osborne, N & Thorkeldsen, A 2015, 'Can specific loading through exercise impart healing or regeneration of the intervertebral disc?' Spine Journal, pp. 2117-2121.

Can specific loading through exercise impart healing or regeneration of the intervertebral disc? / Steele, James; Bruce-Low, Stewart; Smith, Dave; Osborne, Neil; Thorkeldsen, Arvid .

In: Spine Journal, 2015, p. 2117-2121.

Research output: Contribution to journalArticle

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T1 - Can specific loading through exercise impart healing or regeneration of the intervertebral disc?

AU - Steele, James

AU - Bruce-Low, Stewart

AU - Smith, Dave

AU - Osborne, Neil

AU - Thorkeldsen, Arvid

PY - 2015

Y1 - 2015

N2 - BACKGROUND CONTEXT:Low back pain (LBP) is highly prevalent and presents an enormous cost both through direct health care and indirectly through significant work and production loss. Low back pain is acknowledged widely to be a multifactorial pathology with a variety of symptoms, dysfunctions, and a number of possible sources of pain. One source that has been suspected and evidenced for some time is the intervertebral disc. Some degree of disc degeneration is a physiologic process associated with aging, however, more severe degeneration and/or structural abnormality may be indicative of a pathologic process or injury and is more commonly present in those suffering from LBP. Much like other tissues (ie, muscle, bone, etc.), it has been suspected that there exists an optimal loading strategy to promote the health of the disc. Exercise is often prescribed for LBP and effectively reduces pain and disability. However, whether specific loading through exercise might plausibly heal or regenerate the intervertebral discs is unknown.PURPOSE:To examine the effects of loading on regenerative processes in the intervertebral disc and consider the potential for specific exercise to apply loading to the lumbar spine to produce these effects.STUDY DESIGN:A brief narrative literature review.METHODS:Studies examining the effects of loading on the intervertebral discs were reviewed to examine the plausibility of using loading through exercise to induce regeneration or healing of the intervertebral disc.RESULTS:Research from animal model studies suggests the existence of a dose-response relationship between loading and regenerative processes. Although high loading at high volumes and frequencies might accelerate degeneration or produce disc injury, high loading, yet of low volume and at low frequency appears to induce potentially regenerative mechanisms, including improvements in disc proteoglycan content, matrix gene expression, rate of cell apoptosis, and improved fluid flow and solute transport.CONCLUSIONS:Research suggests a dose-response relationship between loading and disc regenerative processes and that the loading pattern typically used in the lumbar extension resistance exercise interventions (high load, low volume, and low frequency) might impart healing or regeneration of the intervertebral discs. Future research should examine an exercise intervention with in vivo measurement of changes in disc condition. This may provide further evidence for the "black box" of treatment mechanisms associated with exercise interventions.

AB - BACKGROUND CONTEXT:Low back pain (LBP) is highly prevalent and presents an enormous cost both through direct health care and indirectly through significant work and production loss. Low back pain is acknowledged widely to be a multifactorial pathology with a variety of symptoms, dysfunctions, and a number of possible sources of pain. One source that has been suspected and evidenced for some time is the intervertebral disc. Some degree of disc degeneration is a physiologic process associated with aging, however, more severe degeneration and/or structural abnormality may be indicative of a pathologic process or injury and is more commonly present in those suffering from LBP. Much like other tissues (ie, muscle, bone, etc.), it has been suspected that there exists an optimal loading strategy to promote the health of the disc. Exercise is often prescribed for LBP and effectively reduces pain and disability. However, whether specific loading through exercise might plausibly heal or regenerate the intervertebral discs is unknown.PURPOSE:To examine the effects of loading on regenerative processes in the intervertebral disc and consider the potential for specific exercise to apply loading to the lumbar spine to produce these effects.STUDY DESIGN:A brief narrative literature review.METHODS:Studies examining the effects of loading on the intervertebral discs were reviewed to examine the plausibility of using loading through exercise to induce regeneration or healing of the intervertebral disc.RESULTS:Research from animal model studies suggests the existence of a dose-response relationship between loading and regenerative processes. Although high loading at high volumes and frequencies might accelerate degeneration or produce disc injury, high loading, yet of low volume and at low frequency appears to induce potentially regenerative mechanisms, including improvements in disc proteoglycan content, matrix gene expression, rate of cell apoptosis, and improved fluid flow and solute transport.CONCLUSIONS:Research suggests a dose-response relationship between loading and disc regenerative processes and that the loading pattern typically used in the lumbar extension resistance exercise interventions (high load, low volume, and low frequency) might impart healing or regeneration of the intervertebral discs. Future research should examine an exercise intervention with in vivo measurement of changes in disc condition. This may provide further evidence for the "black box" of treatment mechanisms associated with exercise interventions.

M3 - Article

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EP - 2121

JO - Spine Journal

JF - Spine Journal

SN - 1529-9430

ER -