System and methods for diagnosis and treatment of discogenic lower back pain

A method for treating a patient having a spine comprising an epidural space and a posterior longitudinal ligament, wherein the patient has a diseased vertebral disc, wherein the method includes:

• implanting a neurostimulation lead within an anterior portion of the epidural space adjacent to the posterior longitudinal ligament, wherein the neurostimulation lead has a plurality of electrodes that are adjacent to the diseased vertebral disc, wherein the neurostimulation lead is a paddle lead and the plurality of electrodes are disposed on the same side of the paddle lead, wherein the paddle lead is implanted such that the electrodes face the posterior longitudinal ligament;
• and wherein said treating is performed by a person who may select among treatment neurostimulations comprising:
• (1) direct inhibition of initiation and/or propagation of an action potential in one or more afferent nociceptor nerves wherein said afferent nerves are caused to increase their mechanical force threshold above which said afferent nerves initiate and/or propagate an action potential;
• (2) promotion of initiation and/or propagation of an action potential in one or more sympathetic nerves in said posterior longitudinal ligament, whereby initiation and/or propagation of an action potential in one or more afferent nociceptor nerves is caused to be secondarily inhibited;
• and (3) inhibition of initiation and/or propagation of an action potential in one or more sympathetic nerves in said posterior longitudinal ligament, whereby said inhibited sympathetic nerve is hindered from secondarily promoting initiation and/or propagation of an action potential in one or more afferent nociceptive nerves.