• A C Schwarzer, C N Aprill, R Derby, J Fortin, G Kine, and N Bogduk.
• Faculty of Medicine, University of Newcastle, Australia.
• Spine. 1994 Apr 1;19(7):801-6.

Study DesignA prospective cross-sectional analytic approach was taken.ObjectivesThis study sought to determine the relative contribution of the disc and the zygapophyseal joint as a pain source in patients with chronic low back pain.Summary Of Background DataPrevious studies have employed either zygapophyseal joint blocks or discography, but in no studies have both procedures been performed.MethodsNinety-two consecutive patients with chronic low back pain were studied using both discography and blocks of the zygapophyseal joints.ResultsThirty-six patients (39%) had at least one positive discogram as defined by exact pain reproduction, an abnormal image, and a negative control. Eight patients responded to both a screening zygapophyseal joint block using lignocaine and a confirmatory block using bupivacaine. Only three patients had both a positive discogram and a symptomatic zygapophyseal joint.ConclusionsIn patients with chronic low back pain, the combination of discogenic pain and zygapophyseal joint pain is uncommon.

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