Send to

Choose Destination
Global Spine J. 2013 Jun;3(3):145-52. doi: 10.1055/s-0033-1347300. Epub 2013 May 21.

Mechanisms of intervertebral disk degeneration/injury and pain: a review.

Author information

Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.


Degeneration of the intervertebral disk and its treatments are currently intensely investigated topics. Back pain is a condition whose chronic and debilitating nature combined with its prevalence make it a major health issue of substantial socioeconomic importance. Although researchers, and even sometimes clinicians, focus on the degenerated disk as the problem, to most patients, pain is the factor that limits their function and impacts their well-being. The purpose of this review is to delineate the changes associated with disk degeneration and to outline mechanisms by which they could be the source of back pain. Although the healthy disk is only innervated in the external layer of its annulus fibrosus, adjacent structures are plentiful with nociceptive receptors. Stimulation of such structures as a consequence of processes initiated by disk degeneration is explored. The concept of discogenic pain and possible mechanisms such as neoinnervation and solute transport are discussed. Finally, how such pain mechanisms may relate to current and proposed treatment strategies is discussed.


degeneration; intervertebral disk; low back pain; nociception

Supplemental Content

Full text links

Icon for Georg Thieme Verlag Stuttgart, New York Icon for PubMed Central
Loading ...
Support Center