Lower back pain is a ubiquitous condition which will affect almost 90% of human beings at least once during their lifetime. Fortunately, most cases will resolve within 6-12 weeks.
What is Chronic Low Back Pain?
When the lower back pain persists past 12 weeks, it is then considered a chronic condition. Assuming the low back pain is not caused by non-spinal conditions such as hip problems or abdominal, lung, or kidney problems, it becomes more important in determining the exact anatomic cause of the pain so that appropriate treatments can be considered.
Diagnosing Low Back Pain Associated with Discogenic Pain
Based upon medical research, the most common cause of chronic lower back pain is discogenic pain. Discogenic pain refers to pain coming from the lumbar intervertebral disc. This pain differs from the commonly known condition, sciatica, in that there is no significant irritation of a spinal nerve and therefore limited leg pain.
Although an MRI may show disc abnormalities or degenerative changes, an MRI cannot definitely diagnosis the disc as the cause of one’s pain.
When there is a need to determine the exact pain generator, discography (discogram) is the only known way to diagnosis if a disc, and which disc, is the cause of pain.
Medical research done decades ago suggested that discography has limited reliability due to false positive results. False positive results refer to testing, which is positive for a condition even though that condition does not exist in that particular patient. More modern research has demonstrated that discography in fact has reasonable degrees of validity and reliability in diagnosing discogenic back pain. If discography is performed using certain parameters, the incidence of false positive rates is at a reasonably low level to use in determining further treatment. The risks of the discography procedure are also minimal.