Low back pain affects about 8 out of 10 Americans at some point in their lifetime and is a leading cause of work-related disability. Discography is a diagnostic test used by pain management doctors to determine if a specific disc is causing back pain.
One of the most challenging aspects of treating back pain is obtaining an accurate diagnosis. Even a minor ache can indicate a serious injury. For many, what seems like an ordinary muscle strain can be a more serious, underlying chronic condition. Discography can help diagnose the cause of lower back pain or neck pain and lead to a more effective treatment.
Also called a discogram, this procedure was first used in the 1940s to help locate spinal lesions that were causing back pain. Advancements in discography have led to it becoming an optimal diagnostic technique. When noninvasive evaluations like magnetic resonance imaging (MRI) are inconclusive, discography may be the next diagnostic tool for determining the cause of back pain.
Discography is an invasive diagnostic test involving injecting a special dye into one or more discs of the spine. Vertebral discs are cushion-like pads made of cartilage and a jelly-like substance that act as shock absorbers between the bones in the spine. The dye makes the disc visible on a fluoroscope monitor and X-ray film.
As a diagnostic procedure, a discography can help determine if an abnormal vertebral disc is the source of back pain. The test is less about the disc’s anatomy (appearance) and more about its physiology (determining if it is the source of pain).
The procedure works by attempting to recreate a pain similar to that which the patient regularly experiences. If the test reproduces the pain, the disc under examination is considered a source of the problem and can help determine treatment options.
A discography can help diagnose the cause of pain when MRIs, CT scans, and X-rays show no structural issues. A study published in the journal Pain Physician indicated that discography accurately identifies the cause of low back pain. Another study found the use of discography to be more effective than MRI for detecting intervertebral disc ruptures and other conditions.
The procedure is an invasive test, so it is not generally used for an initial evaluation of back pain.
How Does Discography Work?
Discography enables the doctor to view the disc itself, while regular X-rays of the spine only provide a clear image of bones, such as the vertebrae. Myelograms only provide clear images of the spinal canal.
During the procedure, the doctor injects a contrast dye into the disc space. The doctor then observes the patient’s response. If the patient experiences pain similar to their chronic pain condition when the solution is injected, the doctor may have located the pain source. Once the disc responsible for the pain is located, following the discogram, the doctor may also perform a CT exam to help determine the pain’s exact location.
Who Can Benefit from Discography?
Discography is a useful diagnostic method for helping doctors understand the nature of a patient’s persistent back or neck pain. The procedure is often considered for patients who, despite extensive conservative treatment, have disabling lower back pain, groin pain, hip pain, or leg pain.
For individuals who have undergone various tests for chronic pain and received inconclusive results, discography may help find an answer. The procedure has been found to be more accurate than other tests, including MRIs. Once an accurate diagnosis is made, the patient and doctor can discuss the best method of treatment. In some cases, discography may help avoid surgery.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including discography. Using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.