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Related Experiment Video

Updated: Jul 17, 2025

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation
05:42

Full-Endoscopic Isolation Zone Technique for the Treatment of Lumbar Disc Herniation

Published on: April 7, 2023

781

Five Reasons Why Some Herniated Intervertebral Discs are Painless.

Dong Ah Shin1, Min Cheol Chang2

  • 1Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

Journal of Pain Research
|September 6, 2023
PubMed
Summary

Painless herniated intervertebral discs (HIVDs) may occur due to resolved inflammation, mechanical factors, genetic changes, neural circuit reorganization, or individual pain tolerance. Understanding these mechanisms can improve clinical pain management strategies.

Keywords:
herniated intervertebral discinflammationpainlessreorganization

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Last Updated: Jul 17, 2025

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781
Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
04:33

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

409

Area of Science:

  • Neurosurgery
  • Pain Management
  • Spinal Disorders

Background:

  • Herniated intervertebral discs (HIVDs) are a common cause of lower back and leg pain.
  • However, a subset of patients with HIVDs do not experience pain, a phenomenon requiring explanation.

Purpose of the Study:

  • To explore potential mechanisms underlying painless herniated intervertebral discs.
  • To enhance clinical understanding and pain management approaches for HIVDs.

Main Methods:

  • Literature review and synthesis of existing research on pain perception and spinal disorders.
  • Analysis of case studies and proposed etiological factors for painless HIVDs.

Main Results:

  • Five potential reasons for painless HIVDs were identified: insufficient/resolved inflammation, mechanical factors without inflammation, altered gene expression in dorsal root ganglia, spinal dorsal horn neural circuit reorganization, and effective pain coping strategies/high pain tolerance.
  • These factors suggest a complex interplay between biological, neurological, and psychological elements in pain perception.

Conclusions:

  • Painless HIVDs can result from various factors, including inflammatory, mechanical, genetic, neural, and psychological influences.
  • Further research into these mechanisms can refine diagnostic and therapeutic strategies for managing spinal pain.