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Discogenic Pain

Unlike a herniated disk (see section on herniated disks), discogenic pain originates within the disk itself and is not from nerves or other sites. Because of this, discogenic pain is only in the back and does not radiate down the legs.

In order to find the injured disk, you may need an X-ray, CT scan, MRI, or discography. Discography is a procedure where the disk is pierced with a thin needle and a contrast dye is injected. An X-ray shows if the dye entered the disk, and the procedure will cause pain if the disk is injured.

Intradiscal Electrothermal Annuloplasty (IDET) is a treatment first used in 1997 for discogenic pain. It can only be used in certain cases, but when appropriate, it is less expensive and less invasive than surgery, taking only an hour to complete. It is an outpatient procedure, and requires a local anesthetic and IV pain relievers. IDET places a hollow needle into the painful disk. A thin heating wire, placed through the needle into the disk, is heated slowly to 194 degrees Fahrenheit and held there for about 15 minutes. It is thought that the heat closes tears in the disk while also burning the nerve endings in the disk, desensitizing them to pain. Pain relief from IDET usually takes a few weeks to begin. Patients may need to wear a back support or do physical therapy, but they must avoid heavy lifting or rigorous activity for six months after IDET. The long-term results of IDET are not yet known, and it is not yet covered by many insurance plans.