Certain symptoms may indicate that you have discogenic lower back pain. Major characteristics of discogenic lower back pain include:

• Pain that is deep and aching.
• Back pain that is worse than leg pain.
• Inability to sit for long periods of time
• Pain extends to the buttocks or to the backs of thighs.
• Medical examination has found no herniation (bulging) of the disc or prolapse (extreme bulging) of disc material.
• Medical examination has found no evidence of nerve root irritation, referred pain, or abnormal neurological test results.

Discography is a minimally invasive procedure used to diagnose discogenic back pain. Discography can be performed while you’re awake. As in the IDET* procedure, discography involves inserting a needle into an affected disc. Sedation and analgesia are provided to minimize your discomfort.

• Provocation discography involves injecting a small volume of contrast dye into the disc to increase pressure inside the disc and confirm the diagnosis by provoking disc-related back pain.
• If the pain of provocation discography is the same as your usual lower back pain, the procedure has essentially confirmed a diagnosis of discogenic pain. However, the question remains: is just one disc involved?

A comprehensive diagnosis of discogenic lower back pain requires the following:

• Pain produced by provocation discography in the problem disc is recognized by the patient as his or her usual lower back pain.
• Discography in at least 1 (but preferably both) neighboring discs does not reproduce the same pain that is generated by the problem disc.
• After a positive provocation discography test, computed tomography (a CT scan) reveals a significant amount of injury in the outer layers of the suspect disc.

Once you have obtained a diagnosis, it may help to understand more about treating discogenic lower back pain.