01/12/2025
Did you know that your gut health is causally linked to spine health through several mechanisms involving the gut microbiota, immune modulation, and systemic inflammation.
Recent Mendelian randomization studies demonstrate that specific gut microbial taxa are associated with increased or decreased risk of spinal conditions such as intervertebral disc degeneration, low back pain, cervical spondyslosis, and spinal stenosis. For example, genera such as Oxalobacter and Tyzzerella 3 are identified as risk factors for low back pain, while Ruminococcaceae UCG011 and Olsenella are protective.[1][2][3][4]
The "gut-disc axis" describes how gut microbiota can influence the microenvironment of intervertebral discs via three main pathways: translocation of bacteria or bacterial products across the gut barrier, regulation of mucosal and systemic immune responses, and modulation of nutrient absorption and metabolite formation (notably short-chain fatty acids) that affect disc and bone health.[5][6][7] Dysbiosis and increased gut permeability can lead to systemic inflammation, which is implicated in the pathogenesis of spondyloarthritis and other spinal inflammatory diseases.[8][9][10][11][12]
These findings suggest that interventions targeting the gut microbiota—such as probiotics, dietary modification, or therapies aimed at restoring gut barrier integrity—may have potential in the prevention or management of certain spinal disorders. However, further research is needed to validate these therapeutic strategies and clarify the mechanistic pathways involved.[2][4]
Would you like me to summarize the latest clinical trials or systematic reviews evaluating the effectiveness of gut microbiota-targeted interventions (such as probiotics or dietary changes) in preventing or treating specific spinal conditions like low back pain or disc degeneration?
References
1. Genetically Predicted Causal Effects of Gut Microbiota on Spinal Pain: A Two-Sample Mendelian Randomization Analysis. Hong S, Chen L, Zhou X, et al. Frontiers in Microbiology. 2024;15:1357303. doi:10.3389/fmicb.2024.1357303.
2. A Mendelian Randomization Study to Reveal Gut-Disc Axis: Causal Associations Between Gut Microbiota With Intervertebral Disc Diseases. Ge Y, Yang H, Fu Y, et al. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2025;34(6):2052-2065. doi:10.1007/s00586-025-08795-z.
3. Association Between Gut Microbiota and Spinal Stenosis: A Two-Sample Mendelian Randomization Study. Li J, Wei J, Wang J, et al. Frontiers in Immunology. 2024;15:1360132. doi:10.3389/fimmu.2024.1360132.
4. Gut-Disc Axis: A Mendelian Randomization Study on the Relationship Between Gut Microbiota and Cervical Spondylosis. Zhang J, Wang B, Du P, et al. Medicine. 2025;104(7):e41536. doi:10.1097/MD.0000000000041536.
5. Gut-Disc Axis: A Cause of Intervertebral Disc Degeneration and Low Back Pain?. Li W, Lai K, Chopra N, et al. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2022;31(4):917-925. doi:10.1007/s00586-022-07152-8.
6. The Gut-Bone Axis: How Bacterial Metabolites Bridge the Distance. Zaiss MM, Jones RM, Schett G, Pacifici R. The Journal of Clinical Investigation. 2019;129(8):3018-3028. doi:10.1172/JCI128521.
7. Gut Microbiota-Bone Axis. Indrio F, Salatto A. Annals of Nutrition & Metabolism. 2025;81(Suppl 1):47-56. doi:10.1159/000541999.
8. Role of Subclinical Gut Inflammation in the Pathogenesis of Spondyloarthritis. Rizzo A, Guggino G, Ferrante A, Ciccia F. Frontiers in Medicine. 2018;5:63. doi:10.3389/fmed.2018.00063.
9. The Role of the Gut and Intestinal Dysbiosis in the Pathogenesis of Spondyloarthritis. Mauro D, Cai B, Ciancio A, et al. Joint Bone Spine. 2025;92(6):105923. doi:10.1016/j.jbspin.2025.105923.
10. Gut Microbiome and Its Interaction With Immune System in Spondyloarthritis. So J, Tam LS. Microorganisms. 2020;8(11):E1727. doi:10.3390/microorganisms8111727.
11. Revisiting the Gut-Joint Axis: Links Between Gut Inflammation and Spondyloarthritis. Gracey E, Vereecke L, McGovern D, et al. Nature Reviews. Rheumatology. 2020;16(8):415-433. doi:10.1038/s41584-020-0454-9.
12. The Gut-Joint Axis in Spondyloarthritis: Immunological, Microbial, and Clinical Insights. Qaiyum Z, Lim M, Inman RD. Seminars in Immunopathology. 2021;43(2):173-192. doi:10.1007/s00281-021-00845-0.
