Herniated discs may create cycle of back pain, infection in cystic fibrosis

Sep 8 2011
Among the various complications that come with cystic fibrosis (CF), patients with the disease can also experience herniated discs in the lumbar region. Back pain can interfere with therapy to treat CF, and may lead to infections and accelerate death.

CF is a genetic disease that affects glands that produce mucus and sweat. Someone with CF produces mucus that is too sticky and interferes with the lungs and pancreas. Excessive salt in sweat can also make a patient lose electrolytes and dehydrate more quickly. People with CF may have frequent lung infections and difficulty absorbing nutrients from their food. An individual is born with CF if both parents carry a mutant gene; 10 million Americans have this mutation, according to the National Heart Lung and Blood Institute.

Back pain is common in patients with CF, which may be due to the mechanical demands of frequent coughing or the weakening of bones from steroid medications. A new study suggests that lumbar disc herniation (LDH) is not only more common in patients with CF when compared to the general population, but may also interfere with efforts to treat the disease, according to research published in September in Journal of Medical Case Reports.

Doctors managing a CF clinic studied patients who had back pain. In the general population, only about 1 to 2 percent of people have LDH, but in the authors’ clinic, that rate jumped to 6.5 percent. The researchers studied three patients who had CF and also experienced LDH. One patient needed spine surgery to relieve the pressure on his lumbar area, and subsequently needed supplemental oxygen for two days after surgery. Another patient experienced back pain that was so severe that she could not perform therapeutic lung exercises, and her lungs were too fragile to endure spine surgery. She contracted several lung infections and eventually died.

Past studies have linked chronic coughing with changes in the lumbar region. After combining this link with malnutrition and the mutual aggravation of psychological stress and physical pain, the new study hypothesizes that LDH and CF create a vicious cycle of pain and infection. While the researchers acknowledge the higher rate of LDH in their clinic may be coincidental, they believe the association between lumbar pain and CF is worth further investigation.