A review of the literature that explores the innervation of the lumbar intervertebral disc.It contains a clarification of the sensory pathways and explores the theory that the disc is mainly supplied by the sympathetic nervous system. The author discussed the findings of sensory nerve endings in a degenerative lumbar disc which penetrate into the nucleus pulposus, normally insensitive in a standard disc.
The author considers the growing evidence to support a 'visceral pain' hypothesis for the nature and mechanism of discogenic pain. He suggests this mechanism is open to 'peripheral sensitisation' and possibly 'central sensitisation' as a potential cause of chronic back pain.
The Journal of bone and joint surgery. British volume.2007 Sep;89(9):1135-9.