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Internal disc disruption and low back pain.

N Sehgal1, J D Fortin

  • 1Spine Technology and Rehabilitation, 7230 Engle Road, Suite 210, Fort Wayne, IN 46804, USA.

Pain Physician
|August 15, 2006
PubMed
Summary
This summary is machine-generated.

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Internal disc disruption causes disabling low back pain in young adults. Diagnosis is challenging, often requiring controversial provocation discography, delaying effective treatment and leading to chronic pain.

Area of Science:

  • Orthopedics
  • Pain Medicine
  • Spinal Surgery

Background:

  • Internal disc disruption is a frequent cause of disabling low back pain in young adults.
  • This condition involves annular fissures that alter the disc's internal structure, often with no external deformation.
  • Clinical diagnosis is difficult due to a lack of objective findings.

Purpose of the Study:

  • To highlight the challenges in diagnosing internal disc disruption.
  • To discuss the controversy surrounding provocation discography as a diagnostic tool.
  • To emphasize the importance of recognizing and treating internal disc disruption to prevent chronic low back pain.

Main Methods:

  • Review of existing literature on internal disc disruption and discogenic pain.
  • Discussion of diagnostic challenges and the role of provocation discography.

Related Experiment Videos

  • Exploration of biochemical/biomechanical models of discogenic pain.

    • Main Results:

    • Internal disc disruption presents diagnostic difficulties without objective clinical signs.
    • Provocation discography is the most convincing diagnostic method but remains controversial.
    • Biochemical/biomechanical models support discogenic pain in subjects without nerve-root compromise.

    Conclusions:

    • A reluctance to acknowledge internal disc disruption as a valid clinical entity hinders timely diagnosis and treatment.
    • Early and aggressive management of internal disc disruption is crucial to prevent long-term disability.
    • Addressing this condition is key to resolving the enigma of chronic low back pain.