Long Island Spine Rehabilitation Medicine is a practice dedicated to relieving pain and restoring function to the spine and other musculoskeletal areas. Discography is one of the diagnostic procedures we perform to determine which disc or discs of the cervical (neck) or lumbar (lower) spine may be causing your pain. It is normally only suggested if conservative treatments, such as physical therapy and ultrasound, have not been successful. Though there is some controversy surrounding discography, our well-respected doctors believe it is a useful diagnostic tool.
The real question in terms of discography rests within understanding what intervention might be suggested once the painful disc level is confirmed. We are hopeful that the months and years ahead may offer newer non-surgical technologies and biologic therapies to help heal earlier stage disc injuries and degeneration.
Why Long Island Spine Is the Place To Come for Discography
Our doctors are highly competent physiatrists — doctors who specialize in pain management and rehabilitation through nonsurgical means. We have a remarkable track record of improving the lives of our patients from our offices in Nassau, Suffolk, and Queens.
Because we are not surgeons, we approach diagnostic procedures without bias. Our only goal is to make you feel better, not to justify the need for an operation. Also, we have expertise in administering diagnostic tests because such tests are an integral part of our daily routine. Any doctor will tell you that discographies must be administered with skill and precision to be of any value and we are experts in this field.
What a Discogram Shows
The discs of the spine are sponge-like cushions between the vertebrae (bones of the spine); discs can be a source of severe back pain if they wear down, herniate, or rupture. Discography (also known as a discogram) works by injecting sterile dye into targeted discs to see whether the resulting pressure provokes a pain reaction.
What is it like to have a discography?
Before the Procedure
You will have to avoid food and beverages the day of the test, and may have to temporarily stop taking blood-thinning medication.
During the Procedure
To begin with, you will receive a mild intravenous sedative to keep you relaxed and calm. You will, however, remain awake because the doctor will need you to give feedback. In some cases an antibiotic will also be administered to prevent infection. As you lie on the table on your side or abdomen, the doctor will cleanse the skin of your back thoroughly and inject a medication to numb the area.
Using fluoroscopic images for guidance, the doctor will insert the discogram needle. If the injected dye remains in the center of the disk, where it was injected, this indicates that the disk is healthy. If the dye spreads outside the center of the disk, however, there is evidence that the disk is damaged, most likely due to wear and tear. This visual evidence, though, is not conclusive because there can be, and often is, disc damage without pain.
This is why the doctor will require your feedback. If, when injected, you experience pain similar to the back pain you have been troubled with, the injected disc is the source of your pain. On the other hand, if you feel little or no pain during the injection, or if the pain you feel during the discogram is completely unfamiliar, the disc is not the cause of your ongoing discomfort. Your answers to the doctor’s questions in regard to your pain level during the procedure will provide the doctor with valuable diagnostic information.
A discogram takes approximately 30 to 60 minutes to perform, though you should allow up to three hours for your visit which will include preparation and recovery time. Also, if more than one disc is being examined, the test will take somewhat longer. Also, remember that you will require someone to drive you home.
After the Procedure
You should expect some pain at the injection site or low back for a few hours after the discography. Although you’ll have to keep your back dry for 24 hours, applying an ice pack to your back for 20 minutes at a time may relieve your discomfort. As with other procedures, there are minimal risks to a discography so you should report any unexpected symptoms, like headache or fever, to us promptly.
What Makes Discography Different from Other Diagnostic Testing
Most diagnostic imaging tests, like MRI or CT scans, concern themselves with the anatomy of the patient, basically planning treatment according to what the patient’s spine looks like. Our doctors, like a great many doctors everywhere, have found that anatomical appearance does not always correlate with pain or function.
It is possible for a person’s back to look badly damaged on an MRI or CT scan despite the fact that the patient experiences only mild discomfort and is fully functional. Conversely, it is possible for such scans to show minimal damage when the patient is in agony.
What differentiates a discogram from these other scans is that the patient’s actual sensations at the point of contact are taken into account. This is very important to the talented professionals at Long Island Spine since we are far more concerned with your personal experience than with any “objective” image. We are more interested in finding out the source of your pain and relieving it than in repairing an atypical image on a screen.
Contact Us for a New Approach to Pain Relief
At Long Island Spine Rehabilitation Medicine, we are innovative and open-minded, responsive to your particular needs. We will listen to you carefully to collaborate with you on the best way to diagnose and treat your pain. We will not give you cookie-cutter advice for unique medical problems. If your symptoms require serious investigation, we will provide it. If you need a discography, we will recommend it. Call us today to find out why so many Long Island patients depend on our capable, compassionate care.