Five Reasons Why Some Herniated Intervertebral Discs are Painless

Abstract

Herniated intervertebral discs (HIVDs) can cause lower back pain and leg pain, but not all cases are painful. We suggest five potential reasons for painless HIVDs. First, when inflammation resolves or is insufficient, pain may not occur. Second, rare cases exhibit motor or sensory deficits without pain, suggesting a mechanical rather than inflammatory component. Third, changes in gene expression within the dorsal root ganglia may prevent persistent inflammation and pain. Fourth, reorganization of neural circuits in the spinal dorsal horn can reduce nociceptive signals and lead to painlessness. Fifth, effective pain coping strategies and higher pain tolerance may mask any discomfort. Understanding these factors can improve clinicians’ knowledge and aid in pain management.

Keywords:

• herniated intervertebral disc
• painless
• inflammation
• reorganization

Abbreviations

CT, computed tomography; DRG, dorsal root ganglia; HIVD, herniated intervertebral disc; MRI, magnetic resonance imaging.

Author Contributions

Both authors (DAS & MCC) made a significant contribution to the work reported, in the conception, study design, execution, acquisition of data, analysis and interpretation; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors reports no conflicts of interest in this work.

Additional information

Funding

This research was supported by the 2023 Joint Research Project of Institutes of Science and Technology.