Gap IVD1: Determine whether post-flight back pain and/or injury are caused by changes to the vertebral body in-flight.
Last Published:  04/20/22 11:43:20 AM (Central)
Responsible Element: Human Health Countermeasures (HHC)
Status: Open

Present state of knowledge

There is an increased incidence of back pain expressed by crewmembers in space.   In addition, herniated IVDs have been diagnosed in returning astronauts (both short-duration and long-duration) on landing day, and after varying periods of time in the postflight period.  Such injuries in astronauts, however, may be related to their careers as aviators (either high performance jet pilots and/or helicopter pilots), although a recent probability assessment for disc herniation in astronauts, presented at a Human Research Program Investigator Workshop (2015) revealed that demographics (gender, height, weight) or previous career as a high performance jet pilot influenced the risk., The evidence of IVD injuries, however, raises the concern that astronauts may be at increased risk during exploration missions following a prolonged sojourn.


Mechanical unloading with space flight is associated with distortions in IVD morphology, with alterations in biochemistry (proteoglycan and collagen content) and with reduced biomechanical forces of muscles. Collectively, reports in the literature suggest that adaptation to the space environment can directly or indirectly induce back pain and may increase the risk for injury when crewmembers are re-subjected to gravity enhanced mechanical forces and torques. Back pain is commonly reported by crewmembers during spaceflight and a chart review of 321 astronauts revealed an increased risk for IVD injury in astronauts following spaceflight, when compared to age-matched control subjects. This review suggests that astronauts may be at increased risk for injury during exploration missions. Space-adapted IVDs might be at risk for injury when reloaded during the performance of mission tasks or when subjected to high G forces with entry and landing; this in-mission risk, however, has not been well defined due to limited descriptions of spaceflight-induced changes to the intervertebral unit.


Research Approach


  1. Perform basic correlation of astronaut data to evaluate the lengthening of the spinal column (associated with space adaptation syndrome) and the risk for IVD damage.
  2. Evaluate whether risk factors for IVD injuries (e.g., previous exposure to high compressive forces, temporal occurrence of IVD injuries after space flight exposure, magnitudes of compressive forces at time of injury) influence the probability of herniated discs.
  3. Evaluate whether astronaut demographics (e.g., gender, height, weight, age) are associated with risk for IVD injury.
  4. Perform a comprehensive description of spaceflight-induced changes to the IVD unit with i) state-of-the-art preflight and postflight measurements  (e/g/. molecular, tissue, biomechanical changes as well as performance outcomes)and ii) with developed in-flight capability/technology.
  5. Define biomechanics of various loading activities during exploration missions, and of representative physical activities after return to Earth, to inform Probabilistic Risk Assessments for IVD injury and for back pain.



Target for Closure
Determine whether the herniated intervertebral discs, spinal nerve compression and back pain manifested in astronauts during and after spaceflight is associated with changes in the intervertebral unit (e.g., intervertebral disc, musculoskeletal attachments and connective tissue) induced by spaceflight (and possibly fractional gravity).
Risk Concern of Intervertebral Disc Damage upon and immediately after re-exposure to Gravity [inactive]
You are here! Gap IVD1: Determine whether post-flight back pain and/or injury are caused by changes to the vertebral body in-flight.

Multi-Disciplinary Research Plans

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