Understanding Discogenic Pain
Discogenic pain is back pain that originates from one or more intervertebral discs. Finding the actual source of the pain is important because disc changes seen on an MRI do not always cause symptoms.
What Is Discogenic Pain?
The intervertebral discs sit between the bones of the spine. They act as cushions, absorb pressure, and help allow movement between the vertebrae.
Discogenic pain occurs when a spinal disc itself becomes a source of pain. This can happen when a disc undergoes degenerative changes, develops small tears or fissures, or becomes irritated.
Discogenic pain is most commonly associated with the lower back, although discs in other areas of the spine can also become painful.
Important Difference
Disc degeneration on an MRI does not automatically mean that particular disc is causing your pain.
How Can a Spinal Disc Become Painful?
Spinal discs naturally change over time. In some people, structural and inflammatory changes within a disc may cause the disc itself to become a source of pain.
Disc Degeneration
A disc may gradually lose hydration, flexibility, and some of its ability to absorb pressure.
Disc Fissures
Small tears or fissures may develop in the outer portion of the disc.
Inflammation
Changes within the disc may contribute to irritation and inflammatory signaling around the damaged tissue.
Pain With Loading
Activities or positions that place pressure on the affected disc may reproduce or increase symptoms.
What Does Discogenic Pain Feel Like?
Discogenic pain is often described as pain centered in the lower back rather than pain that follows a specific nerve down the leg. Symptoms can vary significantly from one person to another.
Certain positions or activities that increase pressure within the spine may make symptoms more noticeable.
Discogenic Pain vs. a Pinched Nerve
These problems can occur together, but they are not necessarily the same condition. Understanding the difference can be important when determining the source of your symptoms.
Discogenic Pain
The spinal disc itself is believed to be the source of pain. Symptoms are often concentrated in the back and may change with movement, sitting, bending, or spinal loading.
Nerve-Related Pain
When a nerve root is irritated or compressed, pain may travel away from the spine and can be accompanied by numbness, tingling, or weakness.
Finding the Pain Generator Is the Key
Diagnosing discogenic pain involves putting several pieces of information together. Imaging can identify changes in a disc, but your symptoms and physical examination help determine whether those changes are actually related to your pain.
Detailed medical and pain history
Physical examination
Movement and positioning tests
MRI or other imaging when appropriate
Evaluation for nerve-related symptoms
Additional diagnostic testing when appropriate
In selected cases, additional diagnostic procedures may be considered when the source of chronic back pain remains unclear.
How Is Discogenic Pain Treated?
Treatment depends on your symptoms, physical examination, diagnostic findings, and how much the pain is affecting your movement and everyday activities.
Initial treatment may include activity modification, medication, physical therapy, exercise, and other conservative approaches. If symptoms continue, your provider may discuss additional interventional or minimally invasive options based on the specific source of your pain.
Treat the Source, Not Just the MRI
Degenerative discs are common, but not every abnormal-looking disc is painful. Utah Spine & Pain evaluates your symptoms, physical examination, and imaging together to determine whether a spinal disc may actually be contributing to your pain and which treatment options may be appropriate.
Pain Doesn’t Have to Define Your Life
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