Pain Management Community

My understanding of this procedure is that it is totally barbaric. They usually insist on doing it if they are planning to do surgery. Apparently it helps them narrow down exactly what area is causing pain. Other than that I don't know that it has any value as a method of treatment. Someone can correct me if I'm wrong. Personally, if I wasn't planning on having surgery I wouldn't have the procedure done. If you're thinking of having spine surgery read this entire board. Most people will tell you that it works maybe 50% of the time for treating pain.

Yes, i have heard that also about back surgery. I don't really even know how i feel about it, i want to get better but i don't want to get cut open. When i saw my neurosurgeon and told him that PT and injections weren't helping so far, he seemed kind of exasperated and was like "well the next step is a discogram and it's painful but it has to be done so we'll schedule it for you". I really don't feel like he took enough to time to explain it and say "well if you don't want to do this then we can do this instead", etc. I'm just so confused and i kind of feel like i'm being rushed in a way, im worried if i call to postpone they'll be frustrated with me or something. I find myself thinking a lot about the day i hurt my back and thinking "what if i had done this instead..." or "what if i hadn't gone to work that day", which i know is unrealistic but i think back pain is one of the worst injuries because until you have back problems you really have no idea what other people are dealing with, thats why im so happy i joined wedmd so i can talk to people who know what i'm going through!

You need to talk to you doctor and ask what the discogram is going to do for you. Simple as that. Is it diagnostic only? And if it is, what then? What will you do with the results? My orthopedic doctor won't order an MRI unless the results will alter his treatment plan. If, say, my shoulder hurts and he's going to follow a certain protocol regardless of the outcome of an MRI then he won't bother ordering the MRI because he feels it would be a waste of time and money.

If the discogram isn't going to do anything for you pain wise and you're not planning on having surgery then personally, I don't see the reason for having one in the first place. Your doctor can't make you to submit to tests you don't want. You must also face the fact that you may never be pain free, regardless of what happens next. There are only so many things that doctors can do. Sometimes the best you can hope for is a tolerable amount of pain so you can live your life. At that point it's time to see a pain management specialist.

My opinion of any test, especially the expensive ones, is if the results would make a difference in my treatment plan, I might consider it. Otherwise I won't. My understanding of a discogram is that it is only done just prior to surgery to pinpoint the area to be worked on, so if I would not be considering surgery at this point, then I would decline. If I was willing to have surgery, then I would ask what information would be gotten from this procedure, and how would it impact on my care.

I had spinal surgery on my neck and never had a discogram at all. I have also heard they are extremely painful.

Don't feel rushed, this is not an emergency, you should take your time and do your research before you make decisions about invasive procedures. You might see a neurologist and ask for all your treatment options, surgical and otherwise. A second surgical opinion is always a good idea too.

Take care, Annette

Discograms. are used less frequently today than they were years ago. Many orthopedic and Neurosurgeons today believe that a combination of MRI, Cat-scan and myelogram (involving little to no pain) will generate the same level of detailed information.

I would never have a discogram unless I was already planning on surgery and my doctor was able to convince me that it was necessary (over of the combined imaging tests mention in the paragraph above). It can be quite painful.

Another option is to obtain a second opinion from a surgeon in a different group. If both doctors agree that the discogram is necessary (and you plan on surgery), then you may need to bite the bullet.

So i have a question. Discogram still scheduled for next week. however for the last 3 days i have not really been in as much pain as i normally am. I'm so frustrated b/c it is so bizarre. i normally cannot walk my normal "stride", and for the past 3 days it is much improved. i normally am not able to bend backwards AT ALL but the past 3 days i have been able to more than i have in the past 4 months. What in the world is going on? has anybody else had this happen to them? i mean, sometimes i have good days but never 3 in a row. Activity level the same, etc. Any ideas? I did "test" my ability to bend backwards b/c it was so weird to me and i ended up having some shooting pains for the rest of that night but then today--nothing. now im questioning the discogram but b/c of murphy's law im sure if i did that then i will wake up the next day right back to normal. So confused. Contemplating calling my neurosurgeon but i feel as though i've called them 10 times already this week (although it's probably closer to 3 )

Hi love pugs1,

I had this procedure (discogram) done last November. It was recommended by my orthopedist after he had exhausted all other non surgical tx for my lower back pain, & was considering a 2 level fusion. I was in a car accident in 4/08, & injured my knee & lower back. From 4/08 thru 12/09 I had epidural injection 2x, 6 months of PT, rest, anti- inflammatory meds, pain meds, everything but surgery. Also, x-rays, MRI of lumbar back, which showed some herniation at L3/4 & L4/5. Finally at a lose at what to do next, my ortho doc, referred me to Rothman Institute (Philly) for a 2nd opinion regarding fusing L3/4 & L4/5. I had the discogram to determine which discs were damaged & where. It was painful, I won't lie to you about that. The doc performing the discogram is trying to replicate your pain, to narrow down which disc(s) are producing the pain. BTW, the discogram took about 45 minutes, from prep to finish. My pain management doc performed the discogram, which was helpful, because I trust him & have a good doc/patient relationship so far.

I had both discs injected with the dye, as well as a third disc, below the L4/5 (S1?). It did replicate my pain & then some. But I believe it was worth the anxiety of worrying about how much it would hurt & the pain experienced during the procedure. Heres why: I finally got a clear picture, in the form of a CT scan done right after the procedure, that showed where the damage was, & what discs were involved.

I can't say if this procedure is right for you, only you can make that decision. My procedure did help the spine surgeons at Rothman Institute determine I was not a good candidate for fusion. I was told to stay far away from spine surgeons, that they cannot "fix" my type of herniations. I am scheduled for an IDET procedure in both levels on 4/10/09. My pain management doc is performing that procedure, & I am hoping for at least some reduction in the pain.

I would advise researching discogram on the internet. try this website: www.spineuniverse.com I found it helplful.

Good luck with everything, I can relate to your worries.

Hi lovepugs:

first of all, I'm really sorry that you're having so much pain.

I had 2 discograms performed when I was 18. I have to be honest..they are pretty painful. I wouldn't want to repeat the test but I am happy I decided to do it, given the fact that it helped me decide not to have a fusion..which wasn't the right surgery for me at the time (I had a second discectomy instead). At the same time, a lot of physicians no longer do this test because it is so painful and because they aren't so sure that it's worth it as a diagnostic tool. So, if you are considering have a discogram, you must be considering back surgery? (as this is performed to determine which disc to operate on). You said your doctor already diagnosed you with an l5 rupture. Is he concerned you have another disc causing problems as well?? Why wouldn't he simply operate on l5 if your films don't show any other problem areas??

Hi,I have had 2 discograms 1st one was really painful 2nd one was not bad at all. I have had 3 fusions & 8 back surgeries total. My last fusion was Dec.of 2008 so am still recovering,I am on strong narcotics for the rest of my life I think. I have battled this for 30yrs. so I have had every procedure I think. The most important thing for a discogram is to MAKE yourself relax,it is less painful that way. I will keep you in my prayers for a good outcome & low pain. Pammy

Thank you everyone for your replies, i found them very helpful! Moonriver22, do you have any idea why your second discogram wasn't as painful as the first? was it done differently? and Danimal79, my neurosurgeon told me i have a herniated disc at my L-5 S-1, but when i called my GP to get the MRI results (had not seen the neurosurgeon yet), the receptionist said" oh well it looks like you have a bulging or slipped disc, so they want you to see a neurosurgeon"....so i did wonder if there was a difference? i can't see any reason for the neurosurgeon to "exxagerate" my condition but i don't know, this is all new to me, but i have heard they are the same? He told me my next step is pretty much going to be sx (depending on the discogram results) because i have not really responded to my 2 steroid injections and 4 months PT. This is all through worman's comp too, im a vet assistant and my job is very physical; i think if i don't have sx i will probably never be able to come close to being able to perform my usual job duties, and that puts a lot of strain and extra work on my coworkers. my most recent post i had been feeling much better, however i woke up today and everything is right back to being as painful as before, so it must have been a fluke thing. I do have panic attacks so im kind of worried that i'll hyperventilate but moonriver22 you are right, if you think positive and tell yourself to relax, i do feel that that is beneficial. Again, I really really appreciate all the help you all have given me, I'll keep all your tips in mind when i have my procedure!

Hi, I have suffered from low back pain for the past year. I have done a lot of reading about causes and treatments for back pain. I recently rented a book from the library titled "I Got Your Back" written by an M.D. who strongly warned against discograms. He wrote they should be labeled "torchergrams" and he said they don't prove anything. I also work with a woman whose daughter had a discogram about 6 months ago. The mom was in the waiting room while her daughter was having the procedure done and said she could hear her srceaming from the procedure room. The dauhgter, also the patient, said the discogram was even more painful then her intial injury. If I were you I would listen to your gut about a discogram and pass on the procedure.

Discograms. today are rarely used to diagnose general spine problems. That can be done via MRI, Cat-scan and myelogram. However, some surgeons believe that discograms. can provide very useful data when surgery is being planned.

Hi Charles. After reading about these I am left now wondering what my PM Dr was saying to me last week. It's an injection that requires dye......she asked if I was allergic to it....something about feeling the nerve pinch down my leg...etc...sooooo is a Disogram what she was referring to? I'm getting really concerned! I opted for PT although it is of no help.....what they do I do at home and more. Your input would be appreciated. OH. 2 bulding disc s1/L1....nerve root irritation confirmed via nerve cond studies.. Thanks Jackie

Hello, I am so sorry you are in pain! I have been where you are. My problem was never discovered until I had the test. It is somewhat painful, but I hurt constantly anyway and this became a wonderful thing for me, for now I have gotten help. If you are on percocet, this in my opinion will not be any test that you can't indure for a few miniutes. Afterward my doctor gave a pain shot, and I was good to go. Please pray about this, I will pray for you. I hope you get the relief I did.