Diagnostic spine test
What is a discogram?
A discogram (also called discography) is a test that helps find out whether a specific spinal disc is causing your back or neck pain. Using live X-ray guidance, your physician places a thin needle into one or more discs and injects a small amount of contrast dye.
If the injection brings on your usual pain in one disc but not in the discs next to it, that disc is the likely pain source. The dye also shows tears or wear inside the disc on X-ray and on a CT scan taken afterwards.
In shortA diagnostic test that helps pinpoint which spinal disc is causing your pain, used to plan treatment before certain spine procedures.
Is a discogram right for you?
Your physician decides after an exam and a review of your imaging and past treatment. These are the usual signs.
Often considered Good fit
- Back or neck pain that has lasted for months despite physical therapy, medicine or injections
- An MRI that shows several worn or bulging discs, where it is unclear which one hurts
- You and your doctor are considering a disc procedure or surgery, such as endoscopic discectomy, disc replacement or fusion, and need to confirm the right level
Usually not the first step Not yet
- New back pain that has not had a trial of conservative care
- An active infection, or fever on the day of the test
- A bleeding problem, or blood thinners that cannot be paused safely
- Pregnancy
Why we use it selectively
A discogram depends on how you describe your pain during the test, and research has raised questions about whether placing a needle into a healthy disc may speed up wear over time. That is why our physicians order it only when the answer will change your treatment plan, and why an exam and MRI come first.
What to expect, step by step
What happens before, during and after the procedure.
Prepare
We review your imaging and medicines. You may be asked to pause blood thinners (only with your prescribing doctor's approval), skip food for several hours and arrange a driver.
Numb and position
You lie on your stomach for a lower back test or on your back for a neck test. The skin is numbed, and antibiotics are often given to lower the risk of infection.
Guide the needle
Using live X-ray, the physician guides a thin needle into the center of each disc being tested, usually including a nearby disc for comparison.
Inject and report
Dye is injected into one disc at a time. You say whether you feel pain and whether it feels like your usual pain. You are not told which disc is being tested, so your answers stay unbiased.
CT scan
A CT scan is often done shortly afterwards to show exactly where the dye spread inside each disc.
Recover and go home
You rest in recovery for a short time, then go home with your driver. Your physician goes over the results with you at your follow-up visit.
Recovery timeline
Everyone heals differently. Your care team gives you instructions for your situation.
- Same day
Rest. Ice can help with soreness where the needle went in.
- 1 to 3 days
Some soreness and a short flare of your usual pain are common. Most people return to normal activity within a day or two.
- Follow-up
Your physician reviews the discogram and CT results with you and explains your next options.
When to call us
Call us right away if you develop a fever, back pain that keeps getting worse in the days after the test, or new weakness or numbness in your legs or arms.
Benefits and risks
Every procedure has trade-offs. Your physician reviews them with you before you decide.
Possible benefits
- Helps confirm which disc is causing pain when MRI alone cannot
- Can help you and your surgeon avoid treating the wrong level
- Shows tears inside the disc that may not be clear on other scans
- Outpatient test with no incision
Possible risks
- Infection inside the disc (discitis). This is uncommon but serious, which is why antibiotics are used.
- A temporary increase in back or neck pain
- Headache
- Bleeding or bruising at the needle site
- Irritation of a nearby nerve
- Allergic reaction to the dye or medicines
Conditions it is used for
Related treatments
Options your physician may discuss before or after this procedure.
Where we offer Discogram
Available at these Empire offices in New York and New Jersey.
Frequently asked questions
Is a discogram painful?
The test is designed to briefly bring on your usual pain in the disc that is causing it, so some discomfort is expected. The skin is numbed and light sedation is used, and the pain usually settles quickly once the injection stops.
How is a discogram different from an MRI?
An MRI shows what your discs look like. A discogram tests whether a particular disc actually hurts. Many people have worn discs on MRI that cause no pain, so a discogram can help separate the painful disc from the others.
Can I drive home after a discogram?
No. Because of sedation, you need someone to drive you home. Plan to take it easy for the rest of the day.
When will I get my results?
Your physician sees how you respond during the test and reviews the X-ray and CT images afterwards. You go over the full results and your next options at your follow-up visit.
Is a discogram covered by insurance?
Many plans cover a discogram when it is medically necessary, and prior authorization is often required. Our team checks your coverage before scheduling.
Talk to a specialist about Discogram
We will review your symptoms and imaging and explain every option, including non-surgical care.
What Our Patients Say
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