Rheumatology’s role: This is usually a mechanical or nerve-related spine condition treated by our pain and spine physicians. A rheumatologist may be involved when there are signs of inflammatory arthritis, such as morning stiffness, swelling in several joints or abnormal inflammation tests.
For full details on this condition, see our main page: Discogenic Back Pain.
Overview
Discogenic back pain is pain that originates in an intervertebral disc itself, rather than from a pinched nerve. Small tears in the outer ring of the disc (annular tears) and disc degeneration can make the disc a pain generator.
This type of pain is typically felt in the low back and may be worse with sitting or bending forward. Treatment focuses on activity guidance, physical therapy and, for selected patients, procedures that target the disc or the surrounding structures.
Watch and learn
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Common symptoms
- Deep, aching low back pain
- Pain that is worse with sitting or bending forward
- Pain that eases when lying down
- Occasional spread of pain into the buttock or thigh
Causes and risk factors
- Annular tears
- Disc degeneration
- Repetitive loading or injury
- Smoking
How it is diagnosed
Diagnosis usually starts with a conversation about your symptoms and a physical exam. Depending on what we find, your clinician may order X-rays, an MRI or CT scan, or nerve tests. Imaging findings are interpreted together with your exam, because many people have changes on an MRI that do not cause pain.
Treatment options
Self-care and lifestyle
Stay active within comfort, pace activities and change positions often.
Physical therapy and medications
Physical therapy and medicines may help reduce flares.
Injections and nerve blocks
Epidural injections are sometimes used, especially if leg symptoms are present.
Minimally invasive procedures
VIA Disc NP, Intracept (for vertebrogenic pain on MRI) and spinal cord stimulation may be options after evaluation.
Surgical evaluation
Surgical options such as fusion or disc replacement are considered for selected patients.
Frequently asked questions
How is discogenic pain different from sciatica?
Discogenic pain is felt mainly in the back and comes from the disc. Sciatica is caused by irritation of a nerve and is felt mainly in the leg.
Is discogenic pain the same as vertebrogenic pain?
No. Vertebrogenic pain comes from the vertebral endplates next to the disc and has specific MRI findings. Your physician can explain which is more likely in your case.
What can I do at home?
Staying active within comfort, taking walking breaks from sitting and following a physical therapy program are often helpful.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.