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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

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Intradiscal Procedures for Discogenic Low Back Pain: Considerations and Implications - A Narrative Review.

Min Cheol Chang¹, Seoyon Yang²

¹Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Journal of Pain Research

|March 26, 2026

Summary

Intradiscal therapies for discogenic low back pain show promise, particularly platelet-rich plasma (PRP) and pulsed radiofrequency (PRF). However, risks like accelerated disc degeneration limit widespread use, necessitating further research.

Keywords:

discogenic pain discography low back pain procedure pulsed radiofrequency

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Area of Science:

Orthopedics
Pain Management
Regenerative Medicine

Background:

Discogenic low back pain (DLBP) is a common cause of chronic pain, often linked to intervertebral disc degeneration and inflammation.
Intradiscal therapies are minimally invasive procedures aimed at pain relief by modulating nerve signals or reducing inflammation within the disc.

Purpose of the Study:

To review the efficacy and risks of various intradiscal procedures for DLBP.
To assess the potential for these procedures to accelerate disc degeneration.

Main Methods:

Review of existing literature on intradiscal therapies for DLBP.
Evaluation of reported outcomes, including pain relief and adverse events.
Assessment of evidence regarding disc degeneration post-procedure.

Main Results:

Platelet-rich plasma (PRP) and pulsed radiofrequency (PRF) show some promise for DLBP relief.
Limited studies report positive outcomes, and long-term follow-up data is scarce.
Concerns exist regarding needle insertion potentially accelerating disc degeneration, especially with larger needles or repeated procedures. Thermal injury is a risk with IDET and CRF.

Conclusions:

Selected intradiscal procedures like PRP and PRF may offer transient benefits for DLBP.
Heterogeneity in study design, short follow-up periods, and procedural risks hinder definitive recommendations.
High-quality, long-term studies are essential to clarify benefits and risks for routine clinical application.