The fundamental reason why I pursue the diagnosis of discogenic pain is that patients have no other valid alternative. Patients with chronic back pain get caught in a circus. They are told that there is nothing wrong with them medically; or they are told something fallacious such as: they once did have nociception; but that has now ceased; and now they have only a "memory" of that pain. Under those conditions, medical treatment will not help; and the only prospect of treatment is behavioural and physical rehabilitation. But that treatment does not work. The patients still have pain. Yet again they are told that there is nothing wrong. They failed rehabilitation, and the only recourse is to repeat it.
LBP: Controversies in Clinical Practice and Research: 8th Physiatric Summer School p. 49-71