Diagnosis of discogenic back pain can be difficult. There are characteristic findings on physical examination, but these same findings are seen in patients with other types of back pain as well. Imaging studies can be performed, such as MRI.
Discogenic pain is pain originating from a damaged vertebral disc, particularly due to denenegrative disc disease
. However, not all degenerated discs cause pain. Disc degeneration occurs naturally with age.
Once a fully degenerated disc no longer has any inflammatory proteins that can cause pain, the disc enters into a stable position. Hence, discogenic pain rarely occurs after 60 years of age.
Discogenic pain can usually be successfully treated with non-surgical treatments, such as pain medication and physical therapy and exercise, but chronic discogenic pain that is severe and limits the individual's ability to function may need to be treated with surgery.
Damage to the disc occurs naturally or through a twisting injury where the inner and/or outer portions of the disc may tear, exposing or irritating the nerves on the outer edge of the annulus.
The injury can also create excessive micro-motion instability at the adjacent vertebrae because the disc cannot hold the vertebral segment together as well as it used to.
The disc itself has very few nerve endings and no blood supply. Without a blood supply the disc does not have a way to repair itself, and pain created by the damaged disc can last for years, either as a chronic condition or with periodic painful flare ups. The symptoms are most common in individuals age 30 to 60 years old.