Since the 1960s, it has been taught that the disc has no nerve supplies, meaning that it produces no pain. Recent research has shown that this is not accurate. There are two known ways the disc can produce pain.
Disc pain has shown to be the source of many cases of common low back and extremity pain.Some of the most intense extremity pain is due to chemical changes in and around the disc. The disc can spill various substances into the areas around the disc. This produces irritation of the nerves in that specific area. Because the nerves are so intertwined, there may be arm or leg nerves in the region of the fluid leakage. The arm and leg nerves can then become inflamed producing excruciating pain down the arms and legs.
Mechanical degeneration, overuse, can cause a change in the nerve supply. As the disc becomes thin, the number of sympathetic nerves increases. These nerves are more sensitive to pain generators like twisting and bending. Therefore, it takes less and less motion to cause more and more pain. This is why it is common to hear people say things like, “My back went out when I was picking up the kids’ legos off the floor.” It wasn’t that the object being lifted was heavy, it was an issue with disc degeneration and pain signals in the disc.
Chiropractic care can help in both chemical and mechanical back pain. To help mechanical pain, chiropractic removes pressure from the nerves. The disc tissue and tissue of the surrounding area can begin to regenerate and heal. For chemical issues, the release of pressure from the nerves can promote fluid turnover within the disc creating a change in the previous, painful patterns that were producing irritation.
For more information, read:
1. Gjerstad J. Genetic susceptiblity and development of chronic non-malignant back pain. Rev Neurosci. 2007;18(1):83-91.
2. Moon HJ, et al. Annulus fibrosus cells interact with neuron-like cells to modulate production of growth factors and cytokines in symptomatic disc degeneration. 2012 Jan. Spine 37(11):2-9.
3. Stefanakis M, et al. Annulus fissures are mechanically adn chemically conducive to the ingrowth of nerves and blood vessels. 2012 Oct. Spine 37(22):1883-1891.
4. Chou et al. The interventional theray, surgery, and interdiscplinary rehabilitation for low back pain, an evidence-based clinicla practice guideline from the American Pain Society. Spine. 2009 Man 1;34(10):1066-77.
