Lumbar Disc Pain 

There are some clinical features of chronic lower back pain which suggest the pain maybe discogenic in origin but these features are not diagnostic. 

The pain is located in the central lumbar spine; increases with sitting, flexion, coughing, sneezing, carrying and improves with standing and walking. 

Does imaging help define the disc as the source of pain?

Plain Xrays:

• not helpful

 MRI:

• Severe narrowing of a disc with marked loss of signal
• Modic Type I and  II end plate changes extending over 25% of the vertebrae body height
• The presence of annular tears
• An annular tear with a protrusion
• Disc extrusions are more likely to be painful , compared to protrusions or bulges
• A normal nuclear signal of a disc makes it very unlikely that the disc is painful