Discogenic Pain

Have you been told you have discogenic back pain. If so, we have treatments that can help.


Discogenic pain means pain due to a disrupted disc. The internal disruption of a disc can be due to mechanical force such as a car accident or from lifting heaving weight leading to uneven distribution of the weight on the spine. Internal Disruption of a disc can caused by something as trivial as rolling out of bed. The architecture of the disc is that of a
jelly donut with a nucleus pulpolsus as the jelly filled center and the annulus as the doughy outer material. The nulceus pulpolsus, the center of the disc, has many pro-inflammatory materials. Therefore, when the disc becomes "leaky" or there is a contained tear to the outer part of the annulus there can be a very intense inflammatory and painful reaction.


Discogenic pain is a diagnosis of exclusion. A provocative discogram can be helpful in identifying your painful disc as well as delineating disc architecture when combined with post-discogram CT scan. It is important that the physician performing these procedures are board-certified in pain medicine and appropriately trained in provocative discography.
MRI findings may also help in some cases. Annular tears may be present on certain MRI sequences.


Again, Discogenic pain is a diagnosis of exclusion. If the patient has tried and failed physical therapy, medications, epidural steroids, facet blocks and an appropriately performed provocative discogram then and only then can a diagnosis of discogenic pain be given. Many current treatments for discogenic pain have the lack of randomized controlled trials and therefore are not paid by insurance companies. Lumbar fusions for discogenic pain have fallen out of favor. Spinal cord stimulator therapy has strong support as a treatment. Many different regenerative medicine procedures are offered across the country. Intradiscal PRP, stem cells,and fibrin are being performed. The idea behind these procedures is
healing of the disc from within and subsequent relief of the patients pain.