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Lumbar Discogenic Pain vs. Lumbar Facet Pain

Anonymous on April 3, 2021 at 7:00 pm
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    • Anonymous
      #68233

      How would I differentiate lumbar discogenic pain from lumbar facet pain on initial examination if my patient has no radicular referral?

      • Abdelfatah AmrAbdelfatah Amr
        Participant
        Joined: Mar 1, 2016
        Posts: 3
        #72177

        *discogenic pain is mainly central axial pain increase with flexion forward while facet pain exaggerated by extension0 and axial rotation (facet stress test ) , and is usually paraspinal
        *discogenic pain is central over the spinous process ,
        * applying vibration on the spinous process increases discogenic pain
        many patient would experience both ( discogenic and facetogenic pain ) in the same time when they exhibit disc herniation
        MRI is useful especially if you find disc with high intensity zone HIZ indicating disc degeneration
        diagnostic facet medial branch block using small 0.25ml up to 0.5 ml L.A. could differentiate

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2764347/

          • Ossama Hamdyossamas@hotmail.com
            Participant
            Joined: Sep 9, 2019
            Posts: 2
            #72279

            I agree with Prof. Amer that the difference between a facet-type syndrome and a disc-type syndrome clinically is that disc injuries are very sensitive to forward flexion and rotation and facet injuries and synovitis are very sensitive to extension.

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