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Nerve Growth In Spinal Discs May Be Cause Of Chronic Back Pain LONDON, ENGLAND -- July 18, 1997 -- Many cases of chronic back pain may be caused by the abnormal growth of nerves that penetrate into damaged vertebral discs, French and British researchers report in this week’s issue of The Lancet. Vertebral discs are found between the vertebrae of the spine, where they act as shock absorbers. The inside, or core, of the discs are made of gelatinous material, called the nucleus pulposus, which is surrounded by a ring of tough, elastic fibrous tissue called the annulus fibrosus. In normal, healthy discs, nerves only go as deep as the outer one-third of the annulus fibrosus. In the study, Professor Anthony Freemont and his colleagues at the University of Manchester and the London Clinic in the U.K. and at the Centre Hospitalier Universitaire in Tours, France examined tissue from discs taken from 38 patients who were undergoing surgery for chronic back pain and compared them with discs taken from cadavers of people who had not had back pain. The researchers found that in the discs of the people who had not had back pain, nerves penetrated no deeper than the outer or middle third of the annulus fibrosus. In 46 percent of patients with chronic low back pain, however, the researchers observed that nerves had grown into the inner third of the annulus fibrosus. What’s more, in 22 percent of patients with chronic back pain, they found that nerves had actually penetrated the nucleus pulposus. In most cases these nerves accompanied new blood vessels and so may play a part in control of blood flow. In 14 samples taken from patients with back pain, however, there were isolated nerve fibrils growing unaccompanied by blood vessels that bore deep into the discs. These nerves were only seen in discs from people who had pain. "Our findings strongly implicate these fibrils in the pathogenesis of chronic low back pain," the researchers write. They conclude that it may be possible to prevent or treat low back pain by "inhibition of growth of nerve fibrils into the intevertebral disc" or by finding a way to interfere with their transmission of pain signals to the brain. E-mail this page to a friend or colleague! To print, use this version