top of page

Understanding Lower Back Pain from Discogenic Causes: Differentiating Local Disc Pain from Radicular




Lower back pain is a common affliction that can have a variety of causes, one of which is discogenic pain arising from intervertebral discs. These discs act as cushions between the vertebrae, and when they become damaged or irritated, they can lead to discomfort and pain. It's important to distinguish between local disc pain and radicular pain, as well as to consider the healing times and treatment approaches for these conditions.


Local disc pain refers to discomfort that is primarily centralized around the affected disc itself. This pain may be dull, achy, and aggravated by certain movements or positions like flexion or sitting. On the other hand, radicular pain occurs when a herniated or bulging disc puts pressure on a spinal nerve root, causing pain, tingling, and numbness that radiates down the leg. Distinguishing between these two types of pain is crucial for accurate diagnosis and treatment planning.


Healing times for discogenic pain can vary widely based on the severity of the condition, individual factors, and the chosen treatment approach. While some cases of mild discogenic pain may resolve within a few weeks with conservative measures like rest, physical therapy, and pain management, more severe cases may take several months to heal. Interestingly, diagnosing discogenic pain through imaging techniques like MRI or CT scans has shown limited evidence of accuracy, as many individuals with disc abnormalities on imaging may not experience pain, while others with no apparent disc issues can still have significant discomfort. This is why working with a professional to identify the type of pain is critical.


The human body has a remarkable capacity to heal itself, and intervertebral discs are no exception. Research has shown that discs can indeed heal over time, albeit at a slow pace due to poor blood flow to the affected regions. Disc healing involves a complex process of tissue repair, including cell regeneration and collagen synthesis. It's worth noting that the healing time for discs can span from several months to years, depending on various factors like age, overall health, and the extent of the damage. However long term studies show similar outcomes for surgical and non-surgical intervention.


Recent studies have shed light on the benefits of staying active during the healing process. Contrary to traditional bed rest, engaging in controlled and guided physical activity can help maintain muscle strength, improve blood flow to the affected area, and promote overall healing. Furthermore, research suggests that discs have the potential for full healing, given the right conditions. While complete regeneration may not always be possible, the body's adaptive capabilities can lead to significant improvements in disc health and function.



Lower back pain stemming from discogenic causes can be a challenging and multifaceted issue. Distinguishing between local disc pain and radicular pain is essential for proper diagnosis and treatment. While healing times can vary, the body's natural healing processes, combined with guided physical activity, offer hope for individuals seeking relief from discogenic pain. As research continues to advance our understanding of disc healing, it is becoming increasingly evident that the body has the potential to achieve meaningful recovery from disc-related discomfort.


References:

1. Manchikanti L, Singh V, Datta S, Cohen SP, Hirsch JA. Comprehensive Review of Epidemiology, Scope, and Impact of Spinal Pain. Pain Physician. 2009;12(4):E35-E70.

2. Lotz JC, Fields AJ, Liebenberg EC. The role of the vertebral end plate in low back pain. Global Spine J. 2013;3(3):153-164.

3. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816.

4. Urban JP, Roberts S. Degeneration of the intervertebral disc. Arthritis Res Ther. 2003;5(3):120-130.

5. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine (Phila Pa 1976). 2006;31(18):2151-2161.

6. O'Sullivan K, McAuliffe S, DeBurca N. The effects of eccentric training on lower limb flexibility: A systematic review. Br J Sports Med. 2012;46(12):838-845.

7. Battié MC, Videman T, Levälahti E, et al. The Twin Spine Study: contributions to a changing view of disc degeneration. Spine J. 2009;9(1):47-59.

Comentários


bottom of page