Dr. Jordan Sudberg Answers: Is a Discogram Painful? What You Need to Know

Chronic back pain can be frustrating and confusing, especially when diagnostic imaging like MRI or CT scans doesn’t pinpoint the exact source of discomfort. In these situations, doctors often recommend specialized diagnostic tests, such as a discogram (also called a discography), to help identify whether specific spinal discs are the cause of pain.

However, many patients hesitate before this procedure because they wonder: Is a discogram painful? Pain management specialist Dr. Jordan Sudberg explains everything you need to know about discograms — what they are, how they work, and what kind of discomfort to expect.

What Is a Discogram?

A discogram is an advanced diagnostic test designed to evaluate the health of intervertebral discs in your spine. These discs act as cushions between the vertebrae, allowing flexibility and absorbing shock. When discs degenerate, herniate, or become injured, they can be a significant source of back pain.

Unlike MRI or CT scans, which show structural images, a discogram helps identify whether a specific disc is causing your pain by stimulating it directly.

How Is a Discogram Performed?

Dr. Jordan Sudberg explains that the procedure involves the following steps:

1. Local anesthesia and sedation: The patient is usually awake but sedated to minimize discomfort. The skin and tissues around the spine are numbed with local anesthetic.
   
2. Needle insertion: Using fluoroscopic (X-ray) guidance, the physician carefully inserts a thin needle into the center (nucleus) of the suspected disc(s).
   
3. Injection of contrast dye: Small amounts of sterile dye are injected into the disc to pressurize it slightly. This can reproduce the patient’s typical pain if the disc is indeed the source.
   
4. Pain assessment: The patient is asked to describe any pain sensations during the injection. If the pain produced matches the usual symptoms, the disc is considered a likely pain generator.
   
5. Imaging: After injection, CT scans may be performed to assess the internal structure of the disc and check for tears or abnormalities.
   

Is a Discogram Painful? Dr. Jordan Sudberg Weighs In

Many patients are understandably concerned about pain during the discogram because the procedure intentionally provokes pain to identify problematic discs. Dr. Sudberg clarifies:

“Yes, some discomfort or pain is expected during a discogram, but the procedure is carefully managed to minimize unnecessary suffering. The goal is to reproduce your typical pain at a tolerable level so we can accurately diagnose the source.”

What Does the Pain Feel Like?

• Mild pressure or aching: For discs that are healthy, you may feel little or no pain, just mild pressure as the dye expands the disc.
  
• Familiar back pain or sharp discomfort: If the disc is damaged or a pain generator, the injection may cause pain similar to what you usually experience. This pain may be sharp, aching, or stabbing.
  
• Temporary nature: The pain is usually brief, lasting only a few minutes during the injection. Once the needle is removed, the pain should subside.
  

Dr. Sudberg emphasizes that the procedure is done under controlled conditions with constant monitoring to ensure patient safety and comfort.

Managing Pain During and After the Procedure

While some pain during a discogram is inevitable, several factors help keep it manageable:

• Local anesthesia: Numbing the skin and surrounding tissues significantly reduces pain from the needle insertion.
  
• Sedation: Light sedation helps anxious patients stay calm and tolerate the procedure better.
  
• Experienced physician: Dr. Sudberg’s skill in needle placement and patient communication helps minimize discomfort.
  
• Aftercare: Patients may experience mild soreness or stiffness in the back after the procedure, which usually resolves within a few days.
  

If pain persists or worsens after the discogram, patients are advised to contact their doctor promptly.

Who Should Consider a Discogram?

Dr. Jordan Sudberg recommends a discogram primarily for patients with:

• Chronic back pain lasting more than 3 months with no clear diagnosis from MRI or X-rays
  
• Pain suspected to originate from one or two specific discs, often supported by previous nerve blocks or diagnostic tests
  
• Planning for spinal surgery, where identifying painful discs helps guide the surgeon’s approach
  
• Cases where conservative treatments have failed, and a precise diagnosis is essential
  

A discogram is not typically recommended as a first-line test because it is invasive and can provoke pain.

Risks and Limitations of a Discogram

As with any invasive procedure, discograms carry some risks:

• Infection: Although rare, introducing a needle into the disc can cause infection. Sterile techniques minimize this risk.
  
• Disc damage: There is a small chance that the injection may worsen disc degeneration or cause injury.
  
• False positives/negatives: Some patients may report pain during the procedure unrelated to their usual symptoms, or painful discs may be present in asymptomatic individuals.
  
• Post-procedure soreness: Temporary back pain or stiffness is common.
  

Dr. Sudberg underscores that careful patient selection and technique help reduce complications.

Alternatives and Complementary Diagnostic Tools

In some cases, less invasive tests may be used before considering a discogram:

• MRI: To visualize disc anatomy and detect bulges or degeneration
  
• Nerve blocks: Injections to numb specific nerves temporarily to assess pain sources
  
• Physical examination and history: Thorough evaluation to rule out non-disc causes of pain
  

A discogram is usually reserved for complex cases where other tests have not provided clear answers.

What to Expect After Your Discogram

After the procedure, Dr. Jordan Sudberg advises patients to:

• Rest for the remainder of the day and avoid strenuous activity
  
• Use ice or over-the-counter pain medication for any soreness
  
• Monitor for signs of infection such as fever, redness, or increased pain
  
• Follow up with their pain specialist to review results and discuss next steps
  

The insights gained from a discogram can guide treatment decisions, including physical therapy, injections, or surgical interventions.

Final Thoughts from Dr. Jordan Sudberg

“While a discogram can cause some discomfort, it’s a valuable tool for diagnosing difficult cases of chronic back pain. The brief pain experienced during the procedure is balanced by the potential benefit of identifying the exact pain source and tailoring effective treatment.”

If you suffer from persistent back pain and are considering advanced diagnostics, consult with a pain management specialist like Dr. Jordan Sudberg to discuss whether a discogram is appropriate for you.