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Disc stimulation and patterns of referred pain
Conor W O'Neill1, Marina E Kurgansky, Richard Derby
1Spinal Diagnostics and Treatment Center, Daly City, California 94015, USA. coneill@spinaldiagnostics.com
Spine
|December 18, 2002
Summary
Noxious stimulation of the lumbar intervertebral disc accurately reproduces patients' existing pain patterns. Pain radiation intensity increases with stimulus intensity, potentially extending below the knee.
Area of Science:
- Pain Medicine
- Spinal Diagnostics
- Interventional Pain Management
Background:
- Previous research linked noxious stimulation of spinal structures to referred extremity pain.
- The pattern of pain response from lumbar intervertebral disc stimulation remained uncharacterized.
Purpose of the Study:
- To investigate the pain response pattern from noxious stimulation of the lumbar intervertebral disc.
- To correlate pain characteristics with stimulus intensity and patient symptoms.
Main Methods:
- Prospective, within-subjects observational study.
- 25 patients undergoing intradiscal electrothermal annuloplasty completed pain diagrams.
- Pain provoked during disc heating was analyzed for location, intensity, and familiarity.
Main Results:
- 68% of patients reported exact reproduction of their presenting pain quality and location.
- Pain originated proximally and radiated distally with increasing stimulus intensity.
- No unfamiliar pain was reported during the procedure.
Conclusions:
- Noxious lumbar intervertebral disc stimulation can elicit low back and referred extremity pain.
- The extent of distal pain radiation is dependent on stimulation intensity.
- Disc stimulation may reproduce pain radiating below the knee.