Innervation of "Painful" Lumbar Discs

Abstract

Findings indicate a more extensive disc innervation in the severely degenerated human lumbar disc compared with normal discs. The nociceptive properties of at least some of these nerves are highly suggested by their substance P immunoreactivity, which provides further evidence for the existence of a morphologic substrate of discogenic pain.

The pathogenesis and clinical significance of a high-intensity zone (HIZ) of lumbar intervertebral disc on MR imaging in the patient with discogenic low back pain

“…Moreover, the disc tissue is supposed to be antigenic and may induce the immunoreaction and the recruitment of inflammatory cells that further impede healing. The inflammatory granulation tissue can certainly produce some proinflammatory cytokine and mediators such as prostaglandin E 2 , IL-6, and IL-8 [3] that can sensitize the nociceptors within the painful discs [5,6,7,10]. The discogenic low back pain might occur when the intradiscal pressure increases with the trunk motion such as flexion or extension.…”

Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

“…Progressively small nerve fibers form along with the granulation tissue [70]. Nerve growth factor promotes the collateral sprouting of additional peripheral sensory nerves into the inner AF and the NP, increases nerve survival, and increases the action and sensitivity of nociceptive sensory neurons [1,5,15,17,24,25,46,105].…”

Discogenic pain in acute nonspecific low-back pain

“…Since a radial tear from the nucleus to the surface layer of the annulus and nociceptors were observed in the outermost layer of the annulus in these cases, a rupture extending the outermost layer of the annulus was considered to be the cause of discogenic low-back pain [4,6,9,16]. In patients with discogenic acute nonspecific low-back pain in this study, the radial tears were detected by discography in all patients.…”