Are you suffering from neck or lower back pain and unsure why? OPTIMAL Pain & Regenerative Medicine offers an innovative back pain evaluation test called a discogram to patients living in the Dallas, Ft. Worth and Arlington communities.
Anatomy of the Spine
The spine is a series of building blocks made-up of vertebra that are separated in the front by discs and in the back by facets. When an injury occurs to one of the discs, patients may begin to experience pain.
Discs look like a jelly filled donut. The jelly (called the nucleus) acts as a shock absorber for the spine. The outside donut is called the annulus and acts as the support structure. When the disc tears, the nucleus can push out causing a slipped dics, buldging disc or herniated disc. The nucleus can put pressure on the spinal canal compressing the nerve roots and even the spinal cord. This pressure and compression can lead to pain.
What is a Discogram?
A discogram is a test used to identify the exact source of pain in the neck or lower back. A discogram test stresses one or more discs to reproduce pain in order to identify the exact location and cause of pain. This is the only spinal test that is provocative (the suspected abnormality is deliberately induced by manipulating conditions known to provoke it). The patient will be awake and pain is replicated for a moment. If patient’s reports pain or if cracks are identified in the x-ray or CT scan then the physician can move forward with a diagnosis.
How Does the Discogram Test Work?
The patient is sedated and a needle is placed into the center of the disc’s nucleus that is in question. The location of the needle is key to having a successful evaluation. After the needle is placed, the patient is awakened. Patients will not experience any lingering pain when they awake.
A dye is then injected into the soft center of the disc. This injection can sometimes recreate pain. An X-ray or CT scan will also be used to identify any cracks in the disc’s annulus. To ensure an accurate diagnosis the test will be “blinded” for patients. Patients will not know the sequential order of injections. Once the discogram test is complete doctors can move forward with a diagnosis.
After the Discogram Procedure
Over 90% of the time, discogram results include a non-painful normal disc and a painful torn disc or discs. In this case, the painful disc or discs is the source of neck or lower back pain. The circumstances will determine the optimal treatment option. One of our team members will discuss the benefits and disadvantages to all treatment options.
If patients do not report pain or the X-ray / CT scan does not show any cracks in the disc, then the disc is not the pain generator. In this case, additional tests will be conducted to ensure an accurate diagnosis.