Discogram: Definition, Uses, Benefits, Risks, and What to Expect

Discography, discogram

What is a discogram?

A discogram, also known as a discography, is a medical procedure used to diagnose the source of back pain. During a discogram, a contrast dye is injected into the soft center of one or more spinal discs, and X-rays or other imaging techniques are used to visualize the dye as it spreads through the disc. The procedure can help doctors determine if a particular disc is causing pain, and if so, whether it is due to a tear or other damage to the disc.

When are discograms used?

Discograms are typically used in cases where a patient is experiencing chronic or severe back pain and other non-invasive imaging tests, such as MRI or CT scans, have not been able to identify the source of the pain.

Discograms can help doctors identify which disc or discs may be causing pain, and can help guide treatment decisions. 

Which conditions can be diagnosed using a discogram?

Discograms are primarily used to diagnose conditions related to the intervertebral discs in the spine, which can cause back pain. Some of the conditions that may be diagnosed using a discogram include:

  • Disc herniation: When the soft inner material of a spinal disc pushes out through a tear or weak spot in the outer layer of the disc, it can put pressure on nearby nerves and cause pain.
  • Degenerative disc disease: This is a condition where the intervertebral discs in the spine break down over time, which can cause pain and other symptoms.

What can I expect during the procedure?

Here’s what you can expect during the procedure:

  • Preparation: Before the procedure, you will be asked to change into a hospital gown and lie on your stomach on an x-ray table. You may be given a mild sedative or pain medication to help you relax and reduce any discomfort during the procedure.
  • Local anesthesia: You will be given a local anesthetic to numb the skin and underlying tissues over the injection site.
  • Dye Injection: Using fluoroscopy (real-time X-ray) or CT, your doctor will insert the needle through the skin and into the intervertebral disc space. Once the needle is in place, a small amount of contrast dye is injected into the disc. You may feel some pressure or discomfort as the dye is injected, but the procedure is generally not painful.
  • Imaging: After the dye is injected, the doctor will take a series of X-ray images or CT scans to visualize how the dye spreads through the disc. You may be asked to provide feedback on their pain levels during the procedure, as this can help the doctor determine which disc or discs may be causing pain.
  • Monitoring: After the procedure, you will be monitored for a short time to ensure that there are no complications or adverse reactions to the contrast dye. 

Overall, the discogram procedure typically takes about an hour to complete, although the exact length of the procedure may vary depending on the number of discs being examined and other factors.

Is it painful?

While you may feel some pressure or discomfort during the injection, the local anesthesia should significantly reduce any pain. After the procedure, you may experience some mild pain or soreness at the injection site for a few days, but this can usually be managed with over-the-counter pain medications.

What is the recovery time?

Most patients are able to resume normal activities within a few days following the procedure.

After the procedure, patients may experience some discomfort or soreness at the injection site for a few days. The doctor may recommend applying ice or heat to the injection site or taking over-the-counter pain medications, such as acetaminophen or ibuprofen, to help manage any discomfort.

Patients may also be advised to avoid certain activities or movements for a period of time to allow the injection site to heal. This may include avoiding heavy lifting or strenuous exercise for a few days following the procedure.

What are the risks?

Like any medical procedure, a discogram does carry some risks. While complications are rare, it’s important to be aware of potential risks and discuss them with your doctor or healthcare provider before the procedure.

Some of the potential risks and complications associated with a discogram include:

  • Infection: Any time a needle is inserted into the skin, there is a risk of infection. The risk of infection can be minimized by ensuring proper sterilization techniques and using sterile equipment.
  • Bleeding: The needle used during the discogram procedure can cause bleeding at the injection site. In rare cases, this bleeding can be severe and require medical attention.
  • Nerve damage: The needle used during the discogram procedure can damage nerves in the surrounding area, which can cause pain, numbness, or weakness.
  • Disc herniation: In rare cases, the pressure from the injection of contrast dye during the discogram procedure can cause a disc to rupture or herniate.
  • Allergic reaction: Some patients may have an allergic reaction to the contrast dye used during the procedure. This can include symptoms such as itching, hives, or difficulty breathing.

Is a discogram right for me?

Whether a discogram is right for you depends on your specific medical situation and the recommendation of your doctor or healthcare provider. 

A discogram is typically recommended for patients who have experienced chronic back pain that has not responded to conservative treatments such as physical therapy or medication. 

Before recommending a discogram, your doctor will typically order imaging tests such as X-rays, MRI, or CT scans to help diagnose your condition. If these tests do not adequately diagnose your condition, a discogram may be a reasonable option. 

It is best to talk to your doctor about whether a discogram is the right option for you. 

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for SpineInfo.com.