The gut microbiome and spinal health - is your gut contributing more than we think?

The management of back pain in Physiotherapy departments is usually centred around advice, education and exercise in line with nice guidance and the highest levels of research (Cochrane reviews).

Interestingly, spinal research is starting to develop links between our gut microbiome and conditions such as degenerative intervertebral disc disease. Early research (Sun et al. 2024) has shown a difference in the bacteria of those with healthy discs compared to those with degenerative disc disease (DDD). The bacteria correlated with the same bacteria found in the gut of the same individuals (deceased research donations). These same bacteria are linked to other degenerative conditions such as heart disease, so we are starting to form a picture of what bacteria is useful, and what ones are not.

It is important to state that this research is really only suggesting that there are chemical differences between healthy and degenerative tissues, and it is perhaps unsurprising to know that those who's gut microbiome is less healthy could be at risk of more dehydration than others.

It does however highlight the importance of improving our overall health and that the gut microbiome is part of this, and has a wider impact on what we have in our tissue, but much further research is required to understand how bacteria is transferred around the body and exactly what we can do about it.

Nevertheless, this is interesting and exciting times for back pain management. We need to start looking deeper than giving someone a sheet of exercises when we consider helping those with chronic back pain and consider the diet, exercise, metabolic and cardiovascular factors that contribute to help us function at our best.

What do you think?

Paper:

Unveiling the Gut-Disc Axis: How Microbiome Dysbiosis Accelerates Intervertebral Disc Degeneration

Yu Sun et al. J Inflamm Res. 2024