Lumbar discogenic pain patterns induced by intradiscal heat stimulation

Abstract Aims: The purpose of this study was to determine the distribution of referred pain from lumbar intervertebral discs in chronic discogenic low back pain. Methods: Subjects consisted of seven patients with chronic discogenic lower back pain who underwent intradiscal electrothermal therapy (IDET). Subjects were asked to describe the usual distribution of pain before IDET. If heat stimulation during IDET reproduced the usual pattern of pain, subjects were required to describe the distribution of induced referred pain, which was then drawn on a body diagram. A total of 9 discs were studied. Results: Pain referral maps were constructed using IDET of the lumbar intervertebral discs. Referred pain distributions from intervertebral discs in this study resembled distributions of L2 discogenic pain. Conclusions: The main afferent pathway for pain from the lower intervertebral discs appears to be through the L2 spinal nerve root, from the sinuvertebral nerves.