Discogenic Low Back Pain: A Topical Review

Abstract

Background: Discogenic low back pain (LBP) is a significant medical condition that carries a heavy socioeconomic burden. The pathophysiology, diagnosis and treatment modalities are reviewed in this article.Methods: A review of the English literature addressing discogenic LBP in PubMed until 2015 is undertaken. Results:The various methods of confirming the diagnosis of discogenic pain is elucidated in this article. With regards to the effectiveness of percutaneous treatments, intradiscal methylene blue (MB) and biacuplasty have a weakly positive recommendation. The evidence for intradiscal electrothermal therapy (IDET) is equivocal. Nucleoplasty, intradiscal pulsed radiofrequency (pRF) and rami communicans radiofrequency (RF) have too few studies to allow them to be assessed. Intradiscal RF, steroids, DiscTRODE and L2 block/RF have negative recommendations. Conclusion:More evidence is needed for to allow for a better assessment of the effectiveness of treatment for discogenic pain. Future studies need to adhere to the IASP definition of discogenic pain.