Discography A Diagnostic Procedure Rather Than a Treatment

07 Oct Discography A Diagnostic Procedure Rather Than a Treatment

A casual review of our ‘Treatments’ page introduces patients to a lengthy list of treatments that we offer here at Lone Star Pain Medicine. Discography is on that list. However, we feel it’s important to clarify that discography isn’t a treatment in the traditional sense. It is more of a diagnostic procedure that helps us understand why a patient is experiencing back pain.

Back pain can be caused by a variety of things. When one of the discs is involved, our task is to figure out not only which one, but what is actually affecting it. Are we looking at degenerative disc disease? Is the problem a herniated disc?

Discography is designed as a diagnostic procedure to help us identify problem discs. Utilizing the procedure allows us to be more accurate with diagnosis and, subsequently, better prepared to recommend an appropriate treatment.

When Discography Is Recommended

Like just about every diagnostic procedure, discography isn’t appropriate for every case of back pain. When is it appropriate? Discography is typically recommended:

• After conservative treatments have failed to relieve a patient’s pain.
• When a doctor suspects abnormal discs for which further guidance is needed.
• Prior to spinal fusion surgery (to identify problem discs).

Although discography is considered minimally invasive, it is still invasive, nonetheless. Therefore, it is not normally used as the initial procedure to determine back pain causation. Doctors prefer to try a few other things before moving to discography.

How the Procedure Works

Discography is designed around a fundamental principle: combining a contrast dye with fluoroscopy to look closely at the discs in the back. Unfortunately, one of the side effects of the procedure is additional pain.

Here is a step-by-step description of how the procedure is performed:

1. The patient lies on an exam table, face down.
2. An IV antibiotic may be administered to reduce infection risk.
3. The skin is numbed with a local anesthetic.
4. A needle is inserted into each disc the doctor suspects may be problematic.
5. Contrast dye is injected into each disk. The dye may produce pain.
6. The patient is asked to describe what they feel as the dye is injected.
7. Images of the discs are taken for future analysis.

It is normal for patients to feel pressure from the contrast dye. The dye actually expands the affected disk. This is what causes the pressure. When a patient experiences pain along with that pressure, it is a good sign that the doctor has identified the problematic disk.

Depending on what a doctor finds, more detailed imaging may be required. Regardless, a successful discography helps a doctor diagnose the exact cause of a patient’s pain. From there, appropriate treatments can be offered.

A Few Possible Side Effects

Discography does come with its side effects. Among them are temporary nerve irritation, numbness, and additional pain. Most patients experience a sore back that lasts for a couple of days after the procedure. This is an addition to the back pain that sent them to the doctor to begin with.

Although unusual, it is still possible for patients to have an allergic reaction to the dye. Some patients experience headaches. And because needles are involved, there is always the risk of infection. Note that infection is extremely rare among discography patients.

If you are experiencing persistent back pain and your GP has been unable to help, consider a visit to Lone Star Pain Medicine. Based on an initial physical exam, we may recommend discography as a means of finding the underlying cause of your issue. And if not, we have other treatments to talk about.