No matter how much medicine you take and physical therapy you do, your back pain still doesn't go away? Sometimes, even with MRI and CT scans, it's hard to find the exact cause. Today, we're talking about a special test that your doctor may suggest in such cases. That's the Discogram. This name may be new to you. But don't worry, let's explain it simply.
Simply put, what is this Discogram?
A discogram (sometimes called a discography) is a special imaging test that can help determine the cause of long-term back pain. It can help determine whether a herniated or damaged disc is the cause of your back pain.
Imagine, our spine is made up of a stack of small bones (vertebrae) stacked on top of each other. To prevent these bones from rubbing against each other, there are spongy cushions between them. We call these spinal discs. When these discs are damaged, back pain often occurs.
Doctors usually first order tests like a CT scan or MRI scan to find the cause of back pain. However, there are several reasons why a discogram may be performed:
- Even after other tests, if more details are needed to confirm the diagnosis .
- If you still have back pain after taking medication and undergoing physical therapy.
- Sometimes this test is also performed before spinal fusion surgery to confirm exactly which disc needs to be removed .
If you have pain in your neck or upper back, a cervical discogram is done. If you have pain in your lower back, a lumbar discogram is done.
There is an important thing to remember here. A herniated disc does not always cause pain. This is why there are different opinions among doctors about this test. However, most doctors believe that it is a good way to confirm a problem that was identified on a CT or MRI scan.
How does this test work?
A discogram uses a technique called fluoroscopy to see how the bones and discs in your spine move. Simply put, it's like a video X-ray . This means your doctor can see what's happening inside in real-time.
In this, the doctor injects a special liquid (contrast material) into each of your spinal discs. This liquid makes the problem areas clearly visible.
- If the fluid remains inside the disc, it means that the disc is healthy .
- If the fluid is spreading out from the outer edge of the disc, it means that the disc may be worn or damaged .
How should you prepare before the test?
Your doctor will advise you on this. In general, you should be aware of the following:
- Tell your doctor about all the medications you take (including vitamins and supplements).
- Be sure to inform us about any allergies you may have.
- If you are pregnant or suspect you are pregnant, you should definitely tell her.
- Bring someone to drive you home. You will be given medication to make you feel dizzy, so you will not be able to drive a vehicle on your own after the test.
What happens during the making of the Discogram?
When you go to the hospital, you will be taken to an X-ray room and made to lie down on a bed. This is done by placing pillows on your side to make you comfortable.
Most of the time, you will be given IV (intravenous) sedation to help you relax during this test. This means that an IV is put into a vein in your arm and you are given some medicine to relax you. Don't worry, the medical team will continue to monitor your oxygen levels, blood pressure, and heart rate throughout the test.
Once you are comfortable, the doctor will follow these steps:
1. First, a small area of the back is numbed with local anesthesia .
2. Then, under X-ray guidance (fluoroscopy), a needle is very carefully inserted into the intervertebral disc .
3. The contrast material is injected into the disc and the needle is removed. This is the most important part. If the disc has been damaged, you may experience the same back pain you always feel. The doctor will ask you about the pain, such as where it hurts.
4. If necessary, do this for several more discs.
5. Finally, a small band-aid is applied to the places where the needle was inserted.
During this discogram, pictures are taken using fluoroscopy. Sometimes, a CT scan or MRI may be done after this. By doing more than one test, the doctor can come to an accurate conclusion about your condition.
From start to finish, this entire process usually takes about an hour.
What to expect after the test?
You may feel some pain and discomfort at the injection site for a few hours after the test. You can relieve this by applying ice at home. Wrap an ice pack in a towel and place it on the painful area for 20 minutes, then remove it for 20 minutes . Do this several times a day. You can also take a pain reliever like acetaminophen or ibuprofen.
Are there any risks in this?
Complications from a discogram are rare , but it's good to be aware of them. Here are some of the possible complications.
| Possible Complications |
|---|
| Infection |
| Bleeding |
| The pain gets a little worse before it gets better. |
| Damage to nerves or blood vessels |
| Temporary numbness or weakness |
| Headaches and Nausea |
| Allergy to contrast fluid |
| Paralysis - This is an extremely rare condition. |
How long does it take to heal?
Most people can return to their normal activities (work, school) within 24 hours, but it may take several days for the pain in the injection sites to completely go away.
What do the test results say?
A radiologist will review your test results and check to see if the contrast fluid has remained inside the disc or leaked out.
- If the fluid remains inside the disc, it is a normal (negative) result. This means that the disc is healthy.
- But if the fluid leaks out of the disc, it indicates that the disc is damaged and worn out. That is an abnormal (positive) result.
The radiologist will send this report to your treating doctor. You will usually be able to discuss the results with them within a week.
What happens next? When should I talk to the doctor ?
If the results are abnormal, the next steps will depend on your situation. Your doctor may decide to do more tests. Or he may recommend surgery to remove the damaged disc and join the vertebrae together (spinal fusion).
| If you have these symptoms, call your doctor immediately. | |
|---|---|
| • | A fever of more than 101 Fahrenheit (38.3 Celsius). |
| • | Discoloration, swelling, warmth, or pus-like fluid draining from the needle site. |
| • | New onset of back pain. |
| • | Worsening of existing back pain. |
How painful is a discogram really?
This is a question that many people ask. It is true that when the contrast medium is injected into a damaged disc, you will feel pain. But the most important thing is that many people say that the pain is very similar to the back pain they feel every day. Although it may be uncomfortable for a while, it will help the doctor to find the exact cause of your pain. Therefore, it is very important to explain to the doctor exactly what pain you are feeling at that moment.
Back pain is a lifelong condition. We understand the frustration and the feeling of "I'll never get better" when you try every treatment but it doesn't work. Not all back pain requires a discogram. But in some cases, this test can help pinpoint the cause of your pain and rule out other conditions. So, if you've been suffering from back pain for a long time, talk to your doctor about it.
Take-Home Message
- A discogram is a special X-ray test used to find the cause of long-term back pain.
- This is usually done when the cause is not clear even after tests like CT or MRI.
- During the exam, you may feel the same pain you always feel. This helps the doctor identify the exact disc that is causing the problem.
- The risk of complications is very low, but if you experience fever, swelling, or increased pain, you should tell your doctor immediately.
- Your doctor is the best person to decide whether this test is right for you, so be sure to discuss everything clearly with him or her.
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