Discogenic low back pain is a complex, multi-factorial, clinical condition. It is characterised by low back pain, with or without the concurrence of radicular lower limb symptoms, in the presence of radiologically-confirmed degenerative disc disease.
Magnetic resonance imaging is the imaging study of choice for degenerative disc disease due to its unique detail on the representation of the disc status. Other tests may include plain radiographs, computed tomography scanning, or provocative discography.
Non-surgical treatments include lifestyle measures, followed by the judicious use of medications, physiotherapy, and therapeutic needling procedures.
Surgical treatment includes decompression of neural structures and, in selected patients, a fusion of the motion segment.
A complex, multi-factorial, clinical condition characterised by low back pain with or without the concurrence of radicular lower limb symptoms in the presence of radiologically-confirmed degenerative disc disease. The pain is exacerbated by activity, but may be present in certain positions, such as sitting.
Progression of disc degeneration may lead to additional painful manifestations, including loss of disc height and facet joint arthrosis, disc herniation and nerve root irritation, and hypertrophic changes resulting in spinal stenosis.
History and exam
Jwalant S. Mehta, MBBS, MS(Orth), D(Orth), MCh(Orth), FRCS(Orth)
Consultant Spine Surgeon
Royal Orthopaedic Hospital
JSM declares that he has received research support from Stryker K2M, Medtronic, and CDMI; is a speaker for AO Spine and Scoliosis Research Society; serves on the editorial board for the European Spine Journal, the Spine Deformity Journal, and the Bone Joint Journal, and is a reviewer for the Global Spinal Journal.
Dr Jwalant S. Mehta would like to gratefully acknowledge Dr Giannoulis Kyriakos and Dr Nasir Quiraishi, previous contributors to this topic. GK and NQ declare that they have no competing interests.
Jayesh Trivedi, FRCS (Orth)
Consultant Spine Surgeon and Head of Department
Centre for Spinal Studies
Robert Jones and Agnes Hunt Hospital NHS Foundation Trust
Alder Hey University Children's Hospital
JT declares that he has no competing interests.
John Ratliff, MD, FAANS, FACS
Department of Neurosurgery
JR declares that he has no competing interests.
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