- Middle back pain
- Low back pain
A discogram is a diagnostic test performed to view and assess the internal structure of a disc and is the most effective test to determine if an intervertebral disc is the source of your pain. MRI scans do not always show tears in discs and it is impossible to diagnose a painful disc without performing a discogram in addition to other tests. This is the most common point of misunderstanding among patients and physicians alike; X-rays alone cannot tell us where pain is coming from.
The discogram can show if a disc is degenerative, if it has begun to rupture or if it has tears in the annulus (outer ring). It is a very valuable diagnostic tool because it increases the success rate of treatments for painful discs by ensuring that only the disc(s) causing pain will be treated.
You will be given medication to help you relax and a local anesthetic is applied to numb the injection area. However, because this procedure is diagnostic in nature as opposed to treatment for pain, a steroid is not injected.
During discography, the physician inserts a needle in the patient’s back into the center of the disc. Radiographic dye is then injected causing pressure within the disc. If injecting the dye recreates the patient’s normal pain, it is then inferred that the specific disc is the source of pain for the patient. If the pain is unlike their normal pain it can be inferred that even though the disc may look degenerative on an MRI scan, it is in fact not the source of the patient’s pain.
This procedure is performed under local anesthesia. Many patients receive additional sedation but it’s important that you remain awake during the test in order to let the doctor know what you are feeling. You will need to arrange for a ride home the day of your procedure. We advise patients to take it easy for a day or so after the test and usually recommend taking a couple days off work after the injection.
Who shouldn’t have this injection?
If you are allergic to any of the medications being injected, if you are on a blood thinning medication (Coumadin, Heparin, Plavix), if you are pregnant or if you have an active infection you should not have this procedure. If you have not responded to local anesthesia you may not be a candidate for this procedure. You should also not have a discogram if you have not already tried simpler treatments such as activity restriction or anti-inflammatory medications.