The intervertebral disc is an important structure, which helps provide flexibility to our spine. It is comprised of a strong outer layer, the annulus, which is rather like a radial tire, and an inner gel, the nucleus, which acts as a sort of shock absorber or cushion between the bones of the spine. With injury or age, these discs can become damaged, causing low back pain. One of the reasons we lose height as we age is that the intervertebral discs lose their water and with that, their height.
An injured disc can be a source of pain. The only way to tell if a disc is the source of your pain is to perform a spinal discogram. There are two ways of performing a discogram procedure. A new technique is called analgesic discography. When doing analgesic discography, we insert a catheter into the disc which we believe is the problem. You then go to the recovery room and perform maneuvers, such as bending, which normally cause you to hurt. We then inject local anesthetic into the disc and have you repeat these maneuvers. If you do not hurt when the disc is numb from the local anesthetic, then we know that disc is the source of your pain.
The second way of doing a discogram is called provocation discography. In provocation discography, we insert a needle into your disc and then inject dye, thus pressuring the disc. During the procedure, you tell us if you feel pain. If you do feel pain, we will then ask whether what you feel is the same or different from the pain you normally feel and how intense is the pain on a scale from 0-10.