Clinical Research Directory

Inclusion Criteria: * Can read and understand English * DEERS eligible * Ages 18-100 * Low back pain duration \> 3 months * Failed an adequate trial of previous conservative treatments for \> 3 months including PT, and oral analgesics, anti-inflammatory medications, or injection therapy within the past 12 months * Average pain score ≥ 4/10 over the past week * Presumed clinical diagnosis of discogenic LBP (such as central, midline back pain exacerbated with flexion and loading; non-radiating; normal sensorimotor exam) * Lumbar MRI within the last 12 months showing disc degeneration in ≤ 2 lumbar discs; Modified Pfirrmann scoring III-VII * Agrees to have disc injection(s) and no other low back interventional (e.g., lumbar epidural steroid injections) or new pharmacological treatments (other than permitted supplemental medications which must be stopped 2 weeks prior to each follow-up) outside of the study for at least 6 months \[Physical therapy (PT), exercise, or psychotherapy are allowed prior to 6 months\] * Agrees to be off all NSAIDs (e.g., aspirin, ibuprofen, Aleve, naproxen, Advil, Motrin, Celebrex) from 2 weeks prior to and 3 months after the injection * Agrees to be off all corticosteroids (e.g., systemic, other injections) for at least 6 weeks after the injection * Stable dose of analgesic medications (excluding NSAIDs) for at least 2 weeks (off schedule 2 opioids for 1 month) Exclusion Criteria: * Pregnancy (Women of childbearing capacity will have pregnancy test to confirm status) * Actively breastfeeding * Low back pain \> 15 years in duration * Previous disc directed therapy involving heat (e.g., Intradiscal electrothermal therapy (IDET), biacuplasty) * Previous disc injection therapy in the last 12 months (e.g., corticosteroid, PRP) * Corticosteroid injections of the low back in the 3 months prior to injection and other corticosteroid therapy (e.g., systemic, other injections) in the 6 weeks prior to injection * Previous lumbar spine surgery (e.g., discectomy, fusion) at the affected levels (i.e., those with relief after surgery in whom adjacent segment discogenic pain is suspected can be considered on a case-by-case basis) * Focal neurological deficit attributed to disc pathology (i.e., abnormal sensorimotor exam consistent with disc pathology) * Individuals deemed at risk to require systemic steroid over the 6-month study course (e.g., individuals with poorly controlled asthma or COPD, individuals with a poorly controlled autoimmune disease) * Individuals with poorly controlled medical or psychiatric co-morbidities, as determined by their specialist or primary care provider (in those not receiving specialty care) * Poorly controlled medical (e.g., unstable angina, congestive heart failure, poorly controlled diabetes) or psychiatric condition that has required medication adjustments within the past 2 weeks (severe depression or schizophrenia) * Untreated coagulopathy or inability to safely stop anticoagulants * Allergy to contrast dye or local anesthetics * Inability to stop Schedule 2 opioid use within 1 month of enrollment due to chronic pain * Diffuse pain phenotype (e.g., diagnosis of fibromyalgia) * Secondary gain (e.g., ongoing medical board or litigation related to injury) * Anticipated PCS or deployment within 12 months of enrollment