Vertebrogenic pain is a distinct type of chronic pain that originates from damaged vertebral endplates. It is more common in the low back, or lumbar spine, between the L3 and S1 spinal levels.
An endplate is a thin structure situated between the vertebral body and the intervertebral disc. It is made up of two layers – a bony layer, which attaches to the vertebral body, and a cartilaginous layer, which attaches to the intervertebral disc. It facilitates the transport of nutrients to the discs and protects the vertebrae and discs from compressive loads on the spine.
The vertebral endplates are highly susceptible to inflammation and damage from everyday activities and spinal conditions such as lumbar degenerative disc disease. When an endplate becomes damaged, pain signals are transmitted from the endplate to the brain through the basivertebral nerve fibers. This pain is called vertebrogenic pain and occurs in the area surrounding the injured endplate.
The symptoms of vertebrogenic pain are usually localized to the midline region of the low back and characterized by a persistent dull ache or burning pain deep in the low back area. The pain typically flares up while sitting, standing, and bending the spine forward. In some cases, the pain may be referred to the tissues surrounding the spine and the buttocks.
In the initial stages, the symptoms of vertebrogenic pain may be intermittent and less intense, and over time, they can become chronic, occurring with greater frequency and longer duration.