Advanced Disc Degeneration Still Very Painful

Article states “there has been a belief that DD initially causes pain because of the penetration of fluid nuclear material through annular fissures, and that pain eventually resolves as the nucleus becomes fibrotic and can no longer penetrate the fissures”. These old  discs image “black” and a felt to be more painfree – yet the  reverse is true. 

Spine. 2008 Dec 1;33(25):E962-7.
Burned-out discs stop hurting: fact or fiction? Bendix T, Kjaer P, Korsholm L.  abstract

“The percentage of people with LBP was virtually not influenced by grey [milder degeneration] discs, where the fraction with pain during the past year was close to 69% irrespective of the presence or number of grey discs. Black discs, however, increased the corresponding fraction from 60%, if no black discs, to 86% for those with 2 (odds ratio of 2 per number of black disc). The risk for LBP during the past year attributed to black discs was 11%.”

Comment – the adage a disc injury will improve with time is not borne out with this study – it seems the more degenerate a disc becomes, the more likely it is to hurt.

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