Mechanisms of intervertebral disk degeneration/injury and pain: a review
- PMID: 24436865
- PMCID: PMC3854582
- DOI: 10.1055/s-0033-1347300
Mechanisms of intervertebral disk degeneration/injury and pain: a review
Abstract
Degeneration of the intervertebral disk and its treatments are currently intensely investigated topics. Back pain is a condition whose chronic and debilitating nature combined with its prevalence make it a major health issue of substantial socioeconomic importance. Although researchers, and even sometimes clinicians, focus on the degenerated disk as the problem, to most patients, pain is the factor that limits their function and impacts their well-being. The purpose of this review is to delineate the changes associated with disk degeneration and to outline mechanisms by which they could be the source of back pain. Although the healthy disk is only innervated in the external layer of its annulus fibrosus, adjacent structures are plentiful with nociceptive receptors. Stimulation of such structures as a consequence of processes initiated by disk degeneration is explored. The concept of discogenic pain and possible mechanisms such as neoinnervation and solute transport are discussed. Finally, how such pain mechanisms may relate to current and proposed treatment strategies is discussed.
Keywords: degeneration; intervertebral disk; low back pain; nociception.
Conflict of interest statement
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References
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- Anema JR, Schellart AJM, Cassidy JD, Loisel P, Veerman TJ, van der Beek AJ. Can cross country differences in return-to-work after chronic occupational back pain be explained? An exploratory analysis on disability policies in a six country cohort study. J Occup Rehabil. 2009;19:419–426. - PMC - PubMed
-
- Becker A, Held H, Redaelli M. et al.Implementation of a guideline for low back pain management in primary care: a cost-effectiveness analysis. Spine (Phila Pa 1976) 2012;37:701–710. - PubMed
-
- Von Korff M. Studying the natural history of back pain. Spine (Phila Pa 1976) 1994;19(18, Suppl):2041S–2046S. - PubMed
-
- Cheung KM, Karppinen J, Chan D. et al.Prevalence and pattern of lumbar magnetic resonance imaging changes in a population study of one thousand forty-three individuals. Spine (Phila Pa 1976) 2009;34:934–940. - PubMed
-
- Battié MC, Videman T, Levalahti E, Gill K, Kaprio J. Heritability of low back pain and the role of disc degeneration. Pain. 2007;131:272–280. - PubMed
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