Discogenic Low Back Pain
Understanding what differs between painful and non painful DDD provides a valuable direction for appropriate targets in diagnosing chronic, severe discogenic pain. This pathogenic condition is believed to arise from a potent combination of increased nociceptors (pain reporting nerves) and acid within the disc nucleus (inner region of the disc). Both of these factors have been uniquely observed in painful (vs. non-painful) discs, and may in fact indirectly relate to DDD and PG content despite the failure of these indications to reliably predict pain alone. PG is a known inhibitor against nerve in-growth, and its decrease is expected to enhance a permissive environment for innervation into discs. This appears to manifest in nerve in-growth that is observed in the nuclei of discs that are painful, but not of discs that are non-painful. Also, in response to damage accumulation and inflammation in some discs, repair mechanisms become defective due to overworked disc cells in a particularly poorly vascularized, and thus hypoxic environment. This leads to abnormal cellular metabolism and glycolysis, which produces lactic acid (and also alanine) byproduct that drives increased acidity in the disc nucleus. Acidity is a known stimulant to nociceptors by activating ion channels, and it thus follows that nociceptors + acid = pain in discs. Painful discs appear to be identified by in-growth of nociceptors and increased hypoxic acidity in disc nuclei, as may be reliably indicated by changes in disc chemistry per the combination of related chemical biomarkers: PG and LA (and perhaps alanine or "AL").
Any patient suffering from LBP should consult their own doctor, including possible specialists when indicated, to determine the recommended course of diagnostic or therapeutic options available to that patient for their particular condition, and should not direct any decision with respect to their medical care in any way based upon this summary or information on this site - which is intended for general background purposes of our company's direction and mission only.
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