What is the most common pain generator in the lumbar spine?

The intervertebral disc (IVD), specifically the annulus fibrosus and the posterior longitudinal ligament (PLL), is recognized as a significant pain generator in the lumbar spine. The annulus fibrosus surrounds the nucleus pulposus of the disc and provides structural integrity and support. It can undergo degeneration or injury, leading to conditions such as disc herniation, which often results in radicular pain due to nerve root compression.

Additionally, the posterior longitudinal ligament sits directly behind the disc and can also be a source of pain if it becomes inflamed or damaged. The IVD's central role in load-bearing and movement, coupled with its vulnerability to injury from everyday wear and tear, makes it one of the most common sources of back pain in the lumbar region. Recognizing the IVD as a primary pain generator is crucial in diagnosing and formulating treatment plans for patients experiencing lumbar pain.