Back Pain: Neurogenic/ Discogenic

• Symptoms
• Diagnosis
• Treatment Options

In this condition, often called “pinched nerve” or “slipped disc,” the source of pain is injury or irritation to spine structures such as disks, nerves, and muscles. The pain often spreads, usually along the back or down the arm, and can be accompanied by weakness or tingling.

Symptoms:

The back is composed of many structures: the vertebral bodies, disks, nerves, and muscles. Neurogenic (nerve-generated) or discogenic (disc-generated) back pain can result from injury or irritation of any of these structures. Often, the pain is generated by more than one structure. The pain often spreads away from the source, usually along the back or down the arm or leg, and can be accompanied by weakness or tingling.

Diagnosis:

Back pain cause by a bulging disk

Radiological imaging can only produce pictures of a patient’s anatomy, not pictures of his/her pain. Physical examination and imaging, such as Magnetic Resonance Imaging (MRI) or Computed Tomographic (CT) Myelography, can help identify which structure or structures are responsible for the pain (termed the “pain generator” or “target”). It is the job of the VIA Interventional Radiologist to decide if something that looks abnormal on an image is actually the source of the pain, or just an incidental finding. If the abnormality seen in the image is a source of pain, then anesthetizing the abnormality should relieve the pain. If the pain improves, then the abnormality is contributing to the pain. If the pain does not improve, then the abnormality was not the source of the pain.

Treatment Options:

Your physician will determine the treatment that best serves you and your condition. If you are a candidate for a minimally invasive Interventional Radiology treatment, your RANK physician may recommend one of several types of Therapeutic Injections.

There are many types of therapeutic injections—epidural injection, medial branch neurotomy, facet joint injection, and sacro-iliac joint injection, among others. In most instances, a long-acting cortisone medication is placed in area of the “pain generator”. This may reduce the pain for weeks or even months, when it is successful. These injections never cure a spine problem, but they can relieve pain to some degree and reduce inflammation while nature heals, or while physical therapy helps a person control the pain.