Are you also someone who suffers from chronic back pain? Sometimes, no matter how much medication or exercise we take, this back pain does not subside, right? In such cases, today we are going to talk about a special test that doctors use to find out the real cause of your back pain. This is called a discogram or discography.
What is a discogram? What does it mean?
Simply put, a discogram is a special imaging test that can help diagnose the cause of chronic back pain . This test allows your doctor to see if a spinal disc, which is located between the bones in your spine called vertebrae, has worn out or is damaged.
Imagine, our spine is made up of small bones, called vertebrae, stacked on top of each other. These vertebrae are soft, jelly-like parts that act like shock absorbers in a car, like sponges, instead of rubbing against each other. Their main function is to absorb the shock when we move around or lift weights. If any damage occurs to one of these discs, it can be a major cause of back pain.
Usually, doctors first perform tests like ``(CT scan)`` (Computed Tomography scans) or ``(MRI scan)`` (Magnetic Resonance Imaging) to find the cause of back pain. However, in some cases, a discogram may also be required. When is that?
- If more information is needed to pinpoint the cause after other scans.
- If you still have back pain after taking medication and undergoing physical therapy.
- Also, sometimes before performing spinal surgery, such as spinal fusion, surgeons use this discogram test to confirm exactly which disc is the problem and which disc needs to be removed .
You may have heard doctors call it a 'cervical discogram' or a 'lumbar discogram'. These are the same test, but the name varies depending on where in the spine it is done. If you have pain in your neck or upper back, you will have a cervical discogram. If you have pain in your lower back, you will have a lumbar discogram.
Here's an important thing to remember. Even if a spinal disc is damaged, it doesn't always cause back pain . Because of this, there is some controversy in the medical field about the discogram test. However, many doctors believe that a discogram can help confirm something suspicious that was seen on a `(CT)` or `(MRI)` scan.
How exactly is a discogram test performed?
A discogram uses a technique called fluoroscopy to see how your vertebrae and discs move. Fluoroscopy is, in simple terms, like a moving X-ray image . That means you can watch it as if it were a video in real time.
In this test, the doctor injects a special substance, called a 'contrast material/dye', into one of the discs in your spine. This dye helps to clearly see where the problem is.
Imagine, if this dye stays inside the disc, it means that the disc is healthy. However, if the dye spreads beyond the outer limits of the disc, it shows that the disc is worn or torn.
How should I prepare for this test?
Your doctor will give you some instructions to follow before the discogram. These are usually the following:
- You should tell your doctor about any medications you take – including over-the-counter medications and supplements. Also, inform your doctor about any allergies you have.
- Also tell your doctor if you are pregnant or suspect you are pregnant .
- Ask a friend or family member to accompany you to and from the test. Because you will be sedated during this test, you will not be able to drive.
What happens during a discogram test?
When you arrive at your scheduled time for the exam, a member of the medical staff will take you to an X-ray room. There, you will be made to lie down on an examination table. Usually, you will be made to lie down on your side, and pillows will be provided for your comfort.
Most often, a discogram is performed with intravenous (IV) sedation. This means that an IV is put into a vein in your arm or hand and you are given some medicine to help you relax. Your oxygen levels, blood pressure, and heart rate are also monitored throughout the test.
Once you are comfortable, the doctor will take these steps:
1. A local anesthetic will be injected to numb a small area of your back.
2. Under X-ray (Fluoroscopy) guidance, a needle is inserted through your skin into a disc in your spine.
3. The disc is injected with the previously mentioned 'contrast dye' and the needle is removed . (At this time, if there is damage to the disc, you may feel pain similar to your normal back pain. At this time, the doctor may also ask you about the pain, such as where it hurts.)
4. If necessary, repeat steps one through three for other disks .
5. Apply a plaster to stop bleeding from puncture wounds.
During the discogram, the doctor will take pictures using fluoroscopy. Then, they may also do a CT scan or MRI scan. Having more than one imaging test can help the doctor make an accurate diagnosis .
From start to finish, a discogram examination usually takes about an hour .
What happens after the test?
After a discogram, you may feel some pain and discomfort around the puncture site for a few hours. You can reduce this pain 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 as often as needed. You can also take painkillers such as paracetamol (e.g. Tylenol®) or ibuprofen (e.g. Motrin®).
Are there any risks involved?
Complications from a discogram are rare , but there are a few things that can happen:
- Infection.
- Bleeding.
- Back pain gets worse before it gets better.
- Damage to blood vessels or nerves.
- Temporary weakness or numbness.
- Headaches.
- Nausea.
- An allergic reaction to the contrast dye.
- Paralysis (this is very rare).
How long does it take to heal after a discogram?
Most people can return to work, school, and other daily activities within about 24 hours . However, it can take several days for the pain in the area where the needle was inserted to completely go away.
What do my test results say?
A radiologist will look at the results of your discogram and tell you whether the contrast dye is still inside the disc or has leaked out.
- If the die is still inside the disc , it is a normal/negative result. This means the disc is good.
- If the dye has leaked out of the disc , it indicates that the disc has suffered wear-and-tear damage (a positive result).
When will I know the results?
Once the radiologist has finished examining your discogram, they will send the results to your doctor. Once they receive the results, your doctor will talk to you about them. In most cases, you will get the results within a week .
If the results are abnormal, what do you do next?
It depends on your situation. Your doctor may recommend additional imaging tests before deciding on a treatment plan. Or, they may recommend a spinal fusion, which involves removing the damaged disc and fusing the vertebrae together. This can help reduce back pain.
When should I see the doctor again?
After the discogram, if you experience any of the following symptoms , call your doctor immediately :
- If the fever is higher than 101 degrees Fahrenheit (38.3 Celsius).
- If there is any discoloration, swelling, warmth, or pus discharge from the sting site.
- If you start having new back pain.
- If your back pain gets worse .
How painful is a discogram test?
If you have a herniated disc in your spine, you may feel some pain when the doctor injects the contrast dye. Many people say that the pain is very similar to the back pain they experience every day . Although it may be uncomfortable at the time, this pain helps the doctor pinpoint which disc is herniated or torn.
You may feel some discomfort or soreness for a few days after the test. If this happens, take an over-the-counter pain reliever and apply ice several times a day.
What is the difference between a discogram and an MRI scan?
Both are imaging tests that help find the cause of back pain. However, they differ in several ways:
Doctors usually first order a CT scan or MRI scan. They will order a discogram if other imaging tests are needed and more information is needed. An MRI gives a good picture of the structure of the disc, and a discogram is used to determine whether the pain is actually caused by that disc .
Finally...
Chronic back pain can really impact your quality of life. When you've tried every treatment option and nothing seems to work, it's natural to wonder, "Is there ever a solution to this?"
Not everyone with back pain needs a discogram. However, in some cases, this imaging test can help confirm whether a spinal disc has worn out and rule out other conditions. If you are suffering from back pain that is not improving, ask your doctor if a discogram could help with your diagnosis.
` Back pain, discogram, vertebrae, spine, diagnosis, X-ray, back pain
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