Low back pain can have many causes. The pain can be generated from injured muscles, ligaments, joints, nerves, organs, blood vessels, or even just general inflammation. One of the most common sources of musculoskeletal low back pain is an injured intervertebral disc (IVD). It used to be thought that the IVD had no nerve supply, and therefore could not be responsible for causing low back pain. However, anatomists and researchers studying disc structure have demonstrated that this is not the case. Each disc is made up of three main structures: the gelatinous core called the nucleus pulposus, rings of tough fibrous tissue surrounding the gelatinous core called the annulus fibrosis, and two endplates on the top and bottom of each disc made up of hyaline cartilage. Normal, healthy discs have nerves that supply the outer half of the annulus fibrosis. These nerves are primarily for detecting pain. Though intervertebral discs have a nerve supply, healthy discs have few nerves compared to other structures around the disc such as other joints and ligaments. When tears and other injuries occur to the outer annulus fibrosis, the pain nerves in the disc become irritated and can cause low back pain. When a disc is injured, chemicals are released that add to the pain and irritation in the region, and cause new nerve growth into the disc. The type of pain a person with a disc injury experiences can be very variable. It can range from local pain that is dull and achy, referred pain to the buttock and posterior thigh, and sometimes even sharp pain to the leg with symptoms of numbness or tingling due to nerve root involvement.

Research into pain originating from the IVD, or discogenic pain, is an important ongoing endeavor as low back pain is the number one cause of disability in the world. Researchers have found that injured discs have more nerves than healthy discs, and they have even found nerves in the gelatinous core of the disc after a substantial disc injury. They also found that as we age and the disc degenerates, there are more nerves in the disc as well (Garcia-Cosamalon et al., 2010). This means that a person suffering from low back pain due to degeneration or injury is producing more nerves in the area with which to feel the pain they are suffering from. In other words, having back pain often leads to more back pain, which is one of the reasons that back pain becomes a chronic issue for so many people. If you are suffering from back pain don't hesitate to come in to Excellence in Health Chiropractic to have an exam and evaluation with Dr. Ross. Using a series of orthopedic tests and imaging modalities, Dr. Ross will determine the cause of your back pain and treat it accordingly. Break the cycle of chronic back pain and make an appointment with us today. Dr. Ross and his team here at Excellence in Health Chiropractic look forward to serving your healthcare needs and continuing to be a leader in quality healthcare. Take charge of your health and get back to living the life you deserve; and as always, we wish you excellence in health.

Resources:

• • Garcia-Cosamalon, J. del Valle, M. Calavia, M. Garcia-Suarez, O. Lopez-Muniz, A. Otero, J. Vega, J. (2010). Intervertebral disc, sensory nerves and neurotrophins: who is who in discogenic pain? Journal of Anatomy, 217: 1-15.

Link to the Abstract:

• • https://www.ncbi.nlm.nih.gov/pubmed/20456524