Don’t mistake “discogenic low back pain” for a lumbar strain! What is discogenic low back pain (discogenic pain)? How is it different from a herniated disc (lumbar herniation)? The medical profession has long believed that lumbar disc herniation is the main cause of low back pain, and recent studies have found that less than 30% of low back pain is caused by lumbar disc herniation compressing nerve roots, and some scholars even believe that the proportion is less than 1%. Most low back pain, with or without neuralgia of the lower extremities, usually lacks objective neurological signs. This type of low back pain is medically referred to as a “somatic origin of pain within the musculoskeletal tissue of the lumbar spine”. It is now believed that low back pain of somatic origin is primarily of internal lumbar disc origin and is characterized by a normal disc profile with little or no lumbar disc herniation and normal myelograms and CT scans. The main pathological feature is the tearing of the annulus fibrosus (the disc structure consists of the fibrous ring and the nucleus pulposus that is encapsulated within it; the entire disc structure is like the tire of a car, with the annulus rubber resembling the fibrous ring and the vacuum within it being the nucleus pulposus in the case of the disc). It is the most common type of chronic low back pain. This so-called “discogenic low back pain” is usually not recognized by the majority of primary care practitioners. Therefore, when CT or even MRI examinations do not reveal any significant abnormalities, patients are usually treated as “lumbar strain” or “lumbar back fasciitis”, thus delaying the condition. The concept of “lumbar herniation” is almost deeply rooted: a herniated disc compresses or stimulates nerves or corresponding tissues to produce low back pain or low back pain. The clinical diagnosis is usually confirmed by CT or MR. Unlike lumbar herniation, “discogenic pain” in the lumbar spine does not involve a herniated disc in most cases, but is essentially a disruption of the internal structure of the disc and a tear in the annulus fibrosus, which can progress to disc herniation or stagnate, but continues to cause low back pain.