Pain Provocation and Disc Degeneration in Lumbar Discography.
- Author:
Hyun Yoon KO
1
;
Jae Heung PARK
;
Hoon KIM
;
Jin Hwan YANG
Author Information
1. Department of Rehabilitation Medicine, Pusan National University College of Medicine, Korea. drjhyang@medimail.co.kr
- Publication Type:Original Article
- Keywords:
Discography;
Provocation pain;
Disc degeneration
- MeSH:
Back Pain;
Buttocks;
Diagnosis;
Humans;
Intervertebral Disc Degeneration*;
Nociceptors
- From:Journal of the Korean Academy of Rehabilitation Medicine
2003;27(5):747-752
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To determine the relationship between pain provocation and level and disc degeneration in lumbar discography. METHOD: Seventy-one patients with lumbar discogenic pain and total 109 discography were studied. During contrast mediun injection, the patient's pain response was reported. The patients were invited to choose among the following options: 'no pain or only pressure feeling', 'dissimilar', 'similar', and 'exact'. And pain location was chosen among the followings: 'low back', 'buttock', 'anterior thigh', 'posterior thigh', and 'lateral thigh'. Correlation between degeneration and provocation response was analyzed. And discography level and provocation area were evaluated. RESULTS: Low back and buttock area was the most common provocation pain site, but it was not specific by disc level. And provocation pain frequently appeared in irregular and fissured types, but the existence of provocation pain was significantly low in ruptured type. CONCLUSION: There was no correlation between provocation pain area and discography level. And existence rate of provocation pain in ruptured disc was very low. It might be due to low mechanical compression with little stimulation of nociceptor. We suggested that if patients have a ruptured disc with chemical irritation, provocation pain was not a good indicator of diagnosis of discogenic back pain.
