{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:41:56Z","timestamp":1792190516335,"version":"4.4.0"},"reference-count":301,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,27]],"date-time":"2025-07-27T00:00:00Z","timestamp":1753574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Discogenic low back pain can be severely disabling, clinically challenging to diagnose, and expensive to treat. Disc degeneration is characterized by disc dehydration, which diminishes the ability of the disc to distribute pressure, making it more susceptible to damage, and leading to annular tears, fissures, and a higher incidence of herniation. Furthermore, the abnormal annular in\u2010growth of nerves and inflammation of the disc increase the number and sensitivity of nociceptors, leading to chronic discogenic low back pain (CDLBP). The purpose of this article was to review the current literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this narrative review, the literature on the diagnosis and treatment of discogenic low back pain was summarized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Symptoms and findings during physical examination may guide the diagnostic process but are not specific or sensitive regarding CDLBP. Magnetic resonance imaging (MRI) can rule out other pathology and provides a basis for the decision about whether to perform pressure\u2010controlled provocative discography, the current diagnostic standard. Conservative care includes pain education programs, structured exercise therapies, psychological interventions, and pharmacological treatment. Various minimally invasive interventional treatment strategies for refractory CDLBP exist, of which biacuplasty or cooled radiofrequency can be used as therapeutic options. Promising new treatments include intradiscal injection of mesenchymal stem cells and platelet\u2010rich plasma, radiofrequency ablation of the sinuvertebral and basivertebral nerves, dorsal root ganglion stimulation, and spinal cord stimulation. Future research regarding the safety and efficacy of these treatments should include large randomized controlled trials with strict inclusion criteria and longer follow\u2010up periods. A primary focus should be on increasing the evidence base for diagnosing discogenic low back pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.70062","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T04:34:18Z","timestamp":1753677258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["14. Discogenic Low Back Pain"],"prefix":"10.1111","volume":"25","author":[{"given":"Wouter K. M.","family":"van Os","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine Amsterdam University Medical Center  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7581-7566","authenticated-orcid":false,"given":"Ricardo","family":"Alvarez\u2010Jimenez","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine Amsterdam University Medical Center  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Anesthesiology, Neurology, Physical Medicine &amp; Rehabilitation and Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Anesthesiology and Physical Medicine &amp; Rehabilitation, Walter Reed National Military Medical Center Uniformed Services University of the Health Sciences  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan P.","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care and Pain Medicine Service VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"VA Bedford Healthcare System  Bedford Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Ruiz\u2010Lopez","sequence":"additional","affiliation":[{"name":"Spine and Pain Surgery Clinica Vertebra  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-2036","authenticated-orcid":false,"given":"Jan","family":"Van Zundert","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care, Emergency Medicine and Multidisciplinary Pain Center Ziekenhuis Oost\u2010Limburg  Genk Belgium"},{"name":"Department of Anesthesiology, Pain Medicine and Neurology Maastricht University Medical Center  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Willem","family":"Kallewaard","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Medicine Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Department of Anesthesiology and Pain Medicine Rijnstate Ziekenhuis  Velp the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2010.00408.x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00098-X"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.01045.x"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.22603\/ssrr.2019-0017"},{"key":"e_1_2_13_6_1","first-page":"1135","article-title":"The Nerve Supply of the Lumbar Intervertebral Disc","volume":"89","author":"Edgar M. 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