Discogenic lower back pain

Question 1

what is DLBP?

Answer 1

pain from the stimulation of pain-sensitive afferents within the annulus fibrosis of intervertebral disc

Question 2

what would a patient present with? 5

Answer 2

1. low back pain without radicular lower limb symptoms
2. sitting intolerances
3. pain on spinous process palpation
4. pain bending forward
5. pain coughing/sneezing

Question 3

MOI 3

Answer 3

1. due to trauma or deterioration due to ageing
2. bent over flexed and twisted lifting something heavy
3. nucleus pulposus migration resulting in a directional preference

Question 4

population 5

Answer 4

weightlifters
gymnasts
golf
cycling
ageing population

Question 5

Imaging to confirm diagnosis 2.

Answer 5

MRI or discography (dye inserted into disc to make visible under fluoroscopy

Question 6

non invasive approach 7

Answer 6

Medication
- anti-inflammatory drugs, anti-depressants, opioids
Physiotherapy
- ultrasound, TENS, massage, strengthening lower back and abdomen

Question 7

exercises 5

Answer 7

• Pelvic tilt
• Knee to chest
• Lower trunk rotations
• Extensions Mckenzie
• birddogs

Question 8

advice

Answer 8

back friendly bodyweight

Question 9

advice

Answer 9

back friendly bodyweight

Question 10

reference info

Answer 10

The causes of discogenic pain and late IVD degenerative changes are also multifactorial and can vary from mechanical overloading, oxidative stress, metabolic disorders, and genetics.

Question 11

reference person

Answer 11

Vergroesen et al 2015

Question 12

Internal Disc Disruption (IDD) 4.

Answer 12

1. disc tears or cracks (fissure)
2. allowing the nucleus pulposus to meet the annulus fibrosus.
3. a chemical called a protecogylcan may be released from the nucleus pulposus.
4. Protecoglycans may irritate the annular nerves causing an inflammatory response and pain