**“OUCH!! My back hurts! I think I must have slept wrong or twisted it in some
way.”**
That’s a perfectly reasonable response to an episode of acute back pain, and certainly could be true, but what if I told you that a lot of back pain is actually due to high levels of cholesterol in the blood?
Surprisingly, this may well be the case, as recent studies have begun to shed light on the intricate relationship between cholesterol levels and chronic back pain, particularly in cases of degenerative disc disease (DDD).
DDD is a condition marked by the deterioration of the discs that cushion the vertebrae in the spine, often leading to chronic pain and disability. As the discs degenerate, they lose their ability to retain water, leading to a reduction in disc height and potentially causing a decrease in the space between adjacent vertebrae, which can result in pain and discomfort.
The role of cholesterol in this process has become a focal point for researchers. High cholesterol levels have been linked to the formation of atherosclerotic plaques in blood vessels, which can impede blood flow.
The arteries that lead to the spinal discs are extremely small. Most of my medical students recall only seeing one or two out of the 30 or so that come out of the aorta when they do a cadaver dissection. So when they get plaque in them, this limits the flow to the discs much more than when they are not blocked at all.
Since the discs in the spine receive nutrition through passive diffusion from these vessels, any reduction in blood flow can adversely affect disc health. This connection suggests that individuals with high cholesterol may be at an increased risk for developing DDD and experiencing more severe back pain as a result.
Furthermore, in vivo and in vitro studies have indicated that excess cholesterol may exacerbate the pathological processes underlying DDD, while cholesterol-lowering drugs could potentially alleviate these effects. A Finnish study in 2006 found that patients with high LDL or high triglycerides had almost three times as much chronic low back pain as patients with normal levels (DOI: 10.1097/01.brs.0000214889.31505.08).
Healthcare professionals emphasize the importance of a holistic strategy that includes physical therapy, exercise, weight management, and, when necessary, surgical interventions to manage the symptoms and progression of DDD. As research continues to evolve, the medical community remains hopeful that a clearer understanding of the relationship between cholesterol and DDD will emerge, leading to more targeted and effective treatments for those suffering from chronic back pain.
In the meantime, it’s perfectly reasonable to adopt lifestyle strategies to lower cholesterol, such as eating more fruits, vegetables, and less saturated fats, as well as taking medications that can protect you from heart attacks, strokes, dementia, and other vascular diseases, as well as back pain!
by Dr. Evan Allen