Discogenic Back Pain: Literature Review of Definition,Diagnosis, and Treatment In this review, we defined the clinical entity of discogenic pain asmultifactorial changes occurring with late IVD degeneration thatinteract with the peripheral nervous system and the CNS toinduce painful conditions. We also described diagnostic criteriaand current treatments of discogenic pain based on a broadclinical literature review,andidentified sourcesof discogenicpainfrom the literature to highlight potential research targets.Discogenic pain encompasses multiple conditions associatedwith IVD degeneration, which makes a single definition limiting.Improved diagnostic methods are helping to more preciselydefine specific pathologies associated with this broad condition.The mostspecificexistingdiagnosticcriteria,suchasdiscography,are invasive with evidence suggesting it can lead to acceleratedIVD degeneration. Clinicians therefore need alternative noninva-sive diagnostic methods that more precisely characterize IVDdegenerative conditions and their specific relationships with theprogression of painful conditions to better inform treatmentoptions. There are a number of treatments/interventions fordiscogenic back pain currently. The lack of a specific diagnosismakes nonoperative management the most importantfirst-linetreatment. Regenerative therapies, such as biologics, cell-basedtherapy, IVD repair, and gene-based therapy, are minimallyinvasive interventions that will likely have advantages over more-invasive current surgical approaches once safety, reliability, andefficacy are shown in human studies.
#science #chiropractor #chiropractic #research #education #evidence based #patient centered #interprofessional #collaborative #rehabilitation #public health #spinal health #musculoskeletal health #ethics #pain #function #disability #QOL #knowledgetranslation
