Discogenic pain stems from degenerative disk disease (DDD), occurring without spinal deformity, radicular pain, neurologic symptoms, or spinal stenosis. Often it arises from disruption of the posterior annulus fibrosis that causes an inflammatory response that activate nociceptive nerve terminals. As noted above, the neurological examination is typically normal, but structural exam may reveal limited ROM and/or antalgic gait as well as para-midline tenderness. Pain may radiate to the buttocks, but generally does NOT extend below the gluteal folds. Pain is frequently exacerbated by standing or sitting and is relieved by lying down.