From the Guidelines
Cervical strain is not directly caused by lumbar degenerative disc disease (DDD), but there may be an indirect relationship through compensatory postures or movement patterns. Cervical strain refers to an injury to the muscles and tendons in the neck, while lumbar degenerative disc disease affects the discs in the lower back. These are two separate conditions affecting different regions of the spine. However, patients with lumbar degenerative disc disease may develop compensatory postures or movement patterns that could potentially increase strain on the neck muscles, indirectly contributing to cervical strain. For example, someone experiencing lower back pain might alter their posture, hold their body differently, or move in ways that place additional stress on the cervical spine. This biomechanical relationship between different regions of the spine is sometimes called regional interdependence. The study on spinal imaging for adult obtunded blunt trauma patients 1 highlights the importance of considering the entire spine when evaluating patients with potential spinal injuries, but it does not provide direct evidence for a causal relationship between lumbar DDD and cervical strain.
- Key points to consider:
- Cervical strain and lumbar degenerative disc disease are distinct conditions
- Compensatory postures or movement patterns may contribute to cervical strain in patients with lumbar DDD
- Evaluation and treatment of both conditions should be considered if a patient is experiencing neck and lower back pain
- It is essential to evaluate the entire spine when assessing patients with potential spinal injuries or conditions, as the relationship between different regions of the spine can be complex.
From the Research
Cervical Strain and Lumbar Degenerative Disc Disease
- Cervical strain can be related to lumbar degenerative disc disease (DDD) due to the biomechanical changes that occur in the spine 2.
- A study found that patients with lumbar DDD had significantly smaller areas of minimal disc deformation at the cephalic adjacent level and the level one above, resulting in larger tensile and shear deformations during end ranges of lumbar motion 2.
- This altered biomechanics can lead to increased stress on the cervical spine, potentially causing strain and other symptoms.
Association between Cervical and Lumbar Degenerative Changes
- Research has shown that degenerative changes in the lumbar spine are positively correlated with degenerative changes in the cervical spine 3, 4.
- A study found that participants with degenerative changes in the upper lumbar segments were more likely to have a certain amount of cervical spondylosis 4.
- Another study found that degenerative changes in both the lumbar and cervical spine were common in asymptomatic subjects, suggesting a tandem disc degeneration phenomenon 3.
Clinical Implications
- The relationship between cervical and lumbar degenerative changes highlights the importance of considering the entire spine when evaluating and treating patients with spinal symptoms 5, 4.
- Clinicians should be aware of the potential for cervical strain and other symptoms in patients with lumbar DDD, and consider evaluating the cervical spine as part of a comprehensive assessment 2, 4.