What will I feel during the discogram?
When a normal disc is injected, you will feel a sense of pressure, but not pain. When an abnormal disc is injected, you will feel pain. It is important to try to tell if the pain you are feeling is your usual pain or different. With each disc injected, you will be asked if it is painful, where you feel the pain and whether it is in the same area as your usual pain.
How many discs will be injected?
Based on your symptoms, your examination and your MRI, we will identify which discs we suspect are causing your pain. These discs will be injected. Rarely do we inject more than three or four disks at one visit. At times only one or two disks may be injected.
How long does a discogram take?
A discogram takes about twenty to thirty minutes per level injected, with the total time depending on how many levels are injected.
What is actually injected?
The injection consists of x-ray dye (x-ray contrast). It may be mixed with some antibiotics to prevent infection. Occasionally local anesthetic or steroid may be injected as well.
Will the discogram hurt?
The discogram involves inserting a needle through skin and deeper tissues, so there is some pain involved. However, your doctor will numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the needle into the disc. Most of the patients also receive intravenous sedation to make the procedure easier to tolerate.
Will I be “put out” for the discogram?
No. This procedure is done under local anesthesia. Injection of a local anesthetic is used to numb the skin. Most of the patients also receive some sedation, to help them relax and make the procedure easier to tolerate. The amount of sedation given depends upon the patient. You can be sleepy while the needles are placed, but during the discogram injections, you need to be awake enough to tell the doctor what you are feeling. Some patients have enough sedation that they have amnesia and may nit remember all or parts of the actual procedure.
Will my pain be better after the discogram?
No. A discogram does not treat your condition. It is a diagnostic test that allows your physician to plan specific treatment for any actual disc problem diagnosed or confirmed by the procedure. You could have a flare-up of your back pain after the injection, but this gets better in a day or two and can usually be managed with ice packs and oral pain medication.
What should I do after the discogram?
All patients will need a ride home. We advise the patients to take it easy for a day or so after the procedure. You may need to apply ice to the affected area for ten minutes at a time every hour or so for the next day. Perform only the activities you can reasonably tolerate.
Can I go to work to work the next day?
Most patients are recommended to rest for 2-3 days after the injection.
What are the risks and side effects of a discogram?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects and possibility of complications. The most common side effect is pain at the injection site, which is temporary. Sometimes, the discogram needle brushes past a nerve root and the nerve root is irritated. This pain usually gets better quickly. The other risks involve infection, bleeding and worsening of symptoms. Infection of a disc or discitis is a serious complication and must be treated with antibiotics. Fortunately, the serious side effects and complications are uncommon.
Who should not have a discogram?
If the patient is allergic to any of the medications to be injected, on a blood thinning medication, has an active infection going on, or has poorly controlled diabetes or heart disease, they should not have the procedure or at least consider postponing it if postponing would improve the overall medical condition of the patient. In general, most patients should not have a discogram without having tried simpler treatments such as rest, medication, physical therapy or other types of injections.
July 25th, 2010