Discogenic low back pains
Isaykin A.I., Ivanova M.A., Kavelina A.V., Sergeeva D.S., Yakhno N.N.

I.M. Sechenov First Moscow State Medical University, Moscow, Russia

The paper focuses on the role of discogenic factor in low back pains. Diagnostic triad, i.e., non-specific pains, pains associated with serious conditions, and compression radiculopathy, is sufficient for a general practitioner to recognize the biological component of low back pains. However, the identification of major pain source is of crucial importance for patients with long-term or recurrent pains to develop treatment strategy which includes blockades, manual therapy, and neurosurgery (as necessary). A cohort of patients with non-specific low back pains is heterogeneous. In 25-42% of patients, these pains are of discogenic origin. Novel effective treatment approaches provide differentiated effects on major pain source. Updated (2014) CTF classification system of lumbar disc hernation is reviewed. Pathogenesis, clinical manifestations, additional diagnostic methods, and differentiated treatment (conservative therapy and surgery) of axial discogenic pain, one of the common manifestations of low back discogenic pathology, are described. The role of inflammation in the development and maintenance of discogenic pains is highlighted. Ketorol use for low back pain relief is discussed.

Key words: back pain, axial discogenic pain, CTF classification system, Modic type 1, Modic type 2, inflammation in disc herniation, disc herniation treatment.

For citation: Isaykin A.I., Ivanova M.A., Kavelina A.V. et al. Discogenic low back pains // RMJ. 2016. № 24. P. 1599–1605.