Back pain can be tricky to figure out but the diurnal disc can elude to the root of the issue if doctors are paying close attention to the history and associated relieving body position.
Spinal symptoms are often diurnal. In other words, patients can often explain the onset of their symptoms based on the time of day or night. A common complaint is stiffness in the morning or after a period of rest while lying down. Early morning stiffness has been thought to be a telltale sign of a degenerative disc. The behaviour of annular fissuring and wedging with the combination of early morning accelerated disc height loss, results in the symptoms of stiffness. To see this you can view the movement of the nucleus in any of our clear bones models.
Patients also complain that back and/or leg symptoms come on later on in the day and into the evening. The diurnal disc can lose up to 20% of its hydraulic height. We do know also, that with height loss, the facets slide and shingle into one another.
You can see well within the contents of the video above, how the disc height can cause a shingling effect of the facets. Facets are pain generators, as can be seen in our medial branch model.
Generally, and I do mean generally, symptoms that come on later in the day are more likely to be from the facet joints. This can be further supported if the patient explains that sitting relieves their symptoms. A further possibility would be stenosis if the patient explains that sitting relieves leg symptoms. We know that sitting both opens the facet joints and the spinal canal of the lumbar spine. This can be seen in many of of our spine models including our Stenosis Degenerated Model.