@article {Boissone000660, author = {Margaux Boisson and Marie-Martine Lef{\`e}vre-Colau and Fran{\c c}ois Rannou and Christelle Nguyen}, title = {Active discopathy: a clinical reality}, volume = {4}, number = {1}, elocation-id = {e000660}, year = {2018}, doi = {10.1136/rmdopen-2018-000660}, publisher = {BMJ Specialist Journals}, abstract = {In the late 1980s, the description by Modic and colleagues of elementary discovertebral changes detected on MRI (Modic classification) suggested for the first time a possible correlation between anatomical and clinical features in a subgroup of patients with non-specific chronic low back pain. Degenerative disc disease is frequent and usually asymptomatic, but Modic 1 changes in the vertebral endplates adjacent to a degenerated disc are associated with inflammatory-like chronic low back pain and low-grade local and systemic inflammation, which led to the concept of {\textquoteleft}active discopathy{\textquoteright}. Active discopathy shares some similarities with acute flares of peripheral osteoarthritis. Likewise, what triggers disc activation and how it self-limits remain unknown. A better understanding of mechanisms underlying disc activation and its self-limitation is of clinical relevance because it may enable the design of more targeted pharmacological and non-pharmacological interventions for the subgroup of patients with chronic low back pain and active discopathy. Here, we narratively review current disc-centred biomechanical and biochemical hypotheses of disc activation and discuss evidence of interactions with adverse personal and environmental factors.}, URL = {https://rmdopen.bmj.com/content/4/1/e000660}, eprint = {https://rmdopen.bmj.com/content/4/1/e000660.full.pdf}, journal = {RMD Open} }