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14. Discogenic Low Back Pain.

Wouter K M van Os¹, Ricardo Alvarez-Jimenez¹, Steven P Cohen^2,3

¹Department of Anesthesiology, Pain and Palliative Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.

Pain Practice : the Official Journal of World Institute of Pain

|July 28, 2025

Summary

This summary is machine-generated.

Chronic discogenic low back pain (CDLBP) is challenging to diagnose and treat. Current treatments range from conservative care to minimally invasive options, with emerging therapies like stem cells showing promise.

Keywords:

chronic discogenic low back pain discography evidence‐based medicine interventional therapy intradiscal therapy

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Area of Science:

Spine Medicine
Pain Management
Regenerative Medicine

Background:

Disc degeneration leads to dehydration, tears, and nerve ingrowth, causing chronic discogenic low back pain (CDLBP).
CDLBP is disabling, difficult to diagnose, and costly to manage.
Understanding disc pathology is crucial for effective pain management.

Purpose of the Study:

To review current literature on the diagnosis and treatment of CDLBP.
To provide an overview of existing and emerging therapeutic strategies.
To highlight the need for further research in CDLBP management.

Main Methods:

Narrative review of existing literature.
Summarization of diagnostic approaches.
Analysis of conservative and interventional treatments.

Main Results:

Physical examination and MRI aid diagnosis, but provocative discography remains the standard.
Conservative treatments include education, exercise, psychological support, and medication.
Minimally invasive options like cooled radiofrequency and promising new treatments such as stem cell injections and nerve ablation exist.

Conclusions:

Accurate diagnosis of CDLBP requires further evidence.
A range of treatments are available, from conservative to advanced interventional.
Future research should focus on large trials for novel therapies like stem cells and nerve ablation.