Chronic back ache may be down to our genes, according to new research.
Three mutations linked to the condition have been identified by scientists.
The breakthrough could lead to new therapies for the world’s leading cause of disability.
It was based on an analysis of the DNA of 158,000 adults of European ancestry, almost one in three of whom were sufferers.
Dr Pradeep Suri, of the Department of Veterans Affairs in the United States, said: “The results of our genome-wide association study point to multiple pathways that may influence risk for chronic back pain.”
It links the risk for with variants in genes controlling the development of bones.
The findings, published in the journal PLOS Genetics, sheds fresh light on the cause of the common problem.
Dr Suri and colleagues say it offers hope of creating better pain relievers.
The researchers said the strongest association was found was with a mutation in a gene known as SOX5.
Interestingly, the protein is involved in almost all phases of embryonic development.
When it malfunctions it has been found to cause defects in cartilage and bone formation in mice.
Dr Suri said this backs the idea it may contribute to chronic back pain through its influence on some aspect of skeletal growth.
The study was replicated in another group of over 280,000 British individuals from the UK Biobank, including over 50,000 with chronic back pain.
A second gene, previously associated with disc hernias, was also linked to back pain, as was a third that plays a role in spinal cord development.
This implicates pain sensation or mood in the possible risk for back pain.
Dr Suri said: “Chronic back pain is linked to changes in mood, and the role of the central nervous system in the transition from acute to chronic back pain is well-recognised.
“However, the top two genetic variants we identified suggest causes implicating the peripheral structures, such as the spine.
“We expect that further large-scale genetic studies will reveal the importance of both peripheral and central contributors to the complex experience of chronic back pain.”
Back pain is a modern-day plague, with four out of five adults experiencing it at some point.
The causes range from a simple pulled muscle to a slipped disc — when one of the spongy cushions between the spinal bones ruptures, causing the disc’s interior to bulge out and press on nerves.
In the UK, it accounts for seven million trips to the GP each year. Most drugs or other treatments offered provide little benefit.
Many patients are needlessly prescribed strong painkillers, given spinal injections or wrongly told to rest or undergo surgery when research shows simple exercises can be more effective.
Dr Suri added: “Back pain is the number one cause of years living with disability, yet very little is known regarding the biology underlying this symptom.
“Identifying pathways involved might suggest potential avenues for the development of new treatments.
His international team included Dr Frances Williams from King’s College London’s Department of Twin Research and Genetic Epidemiology.
By Ben Gelblum and Mark Waghorn