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Updates on Pathophysiology of Discogenic Back Pain
Rohan Jha1,2, Joshua D Bernstock2, Joshua I Chalif2
1Harvard Medical School, Boston, MA 02115, USA.
Journal of Clinical Medicine
|November 14, 2023
Summary
Intervertebral disc (IVD) degeneration causes discogenic back pain through inflammation, neovascularization, and neoinnervation. Current research explores targeted and regenerative therapies for this condition.
Area of Science:
- Biomedical science
- Pain research
- Regenerative medicine
Background:
- Discogenic back pain, a common cause of chronic back pain, stems from intervertebral disc (IVD) degeneration.
- IVD degeneration imposes a significant socioeconomic burden.
- Degeneration alone does not always result in pain.
Purpose of the Study:
- To review the pathophysiology of discogenic back pain.
- To focus on biomechanical and biochemical mechanisms linking IVD degeneration to pain.
- To explore current and emerging therapeutic strategies.
Main Methods:
- Literature review of existing research on discogenic back pain pathophysiology.
- Analysis of biomechanical and biochemical factors in IVD degeneration.
- Examination of inflammatory, angiogenic, and neurogenic pathways.
Main Results:
- IVD degeneration initiates inflammation and immune cell recruitment.
- Chronic inflammation promotes neovascularization and neoinnervation within the IVD.
- Nociceptive sensitization, leading to pain, emerges from these changes.
- Low-virulence infections and CNS metabolic alterations may play complementary roles.
Conclusions:
- Discogenic back pain pathophysiology involves inflammation, neovascularization, and neoinnervation.
- Targeted therapies aim to disrupt these pain pathways.
- Gene and cell-based regenerative therapies offer future treatment possibilities.
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