Discogenic back pain is pain that originates from one or more damaged vertebral discs and is most often due to degenerative disc disease or a herniated or “slipped disc” in the back region of your spine. Not all degenerated discs cause pain. Disc degeneration occurs naturally with age and is not necessarily a painful process. Discogenic pain usually begins with a disc injury that fails to heal properly over time. This results in a highly sensitive disc that causes pain when pressure is applied to it. This is ironic as healthy discs are designed to cushion large loads in the lumbar and cervical spine and normally handle great pressure applied to them without symptoms.
Patients with discogenic back pain, as a rule, are intolerant of sitting. Symptoms of pressure, discomfort, and a dull, deep, aching pain in the midline of the body radiating into the tailbone prevent patients from sitting longer than 5-10 minutes. These symptoms are generally reduced when standing, with activity, and certainly with lying down. Pain is increased when coughing or sneezing and patients learn that they have to brace themselves when doing so to lessen the pain. Pain is worse in the am and is generally better later in the day when activity is greatest.
While discogenic back pain is most often due to degenerative disc disease, any type of disc injury can result in a chronic, degenerative micro-environment inside a disc. This environment is sustained by pro-inflammatory chemicals leaking from the jelly-like nucleus of the disc into the portions of the disc that have a nerve supply that can transmit pain signals to the brain. These chemicals support enzymes that degrade disc cartilage and are toxic to cells in the disc known as chondrocytes that are responsible for keeping disc cartilage healthy. Injury to the disc results from any sudden loading of the disc especially when the supportive musculature is unprepared for such a load. This occurs with poor lifting habits, heavy contact sports including football, hockey, and rugby, accidents including car accidents, falls and with repetitive bending or lifting activities. Even lighter loads can injure a disc especially if combined with a twisting motion of the trunk. Being out of shape or fatigued can increase the risk of these injuries but even highly trained athletes may suffer disc injury if the load is great enough.