Discography (Discogram)

A straightforward Guide for Patients

What Is a Discography?

Discography—often called a discogram—is a diagnostic procedure used to pinpoint which spinal disc may be generating pain. A small amount of contrast dye is injected into one or more discs while using fluoroscopy (live X-ray) for precise needle placement.

Unlike other spinal injections, a discogram is not meant to relieve pain. Instead, it is used to confirm the exact disc causing symptoms so your surgeon and provider can plan the best treatment approach.

Why Is a Discography Done?

Discography is typically recommended when:

  • You have chronic back pain that has not improved with conservative care.
  • Imaging (MRI or CT) shows disc abnormalities, but the source of pain is still unclear.
  • A surgeon needs confirmation before considering spinal fusion or disc replacement.
  • Precise identification of the painful disc is required for surgical planning.

The main goal is to determine which disc reproduces your typical pain, helping guide next steps in care.

How the Procedure Works

Discography is performed in a sterile procedure room using fluoroscopy for accuracy and safety.

  1. Positioning
    You will lie on your stomach or back depending on the area of the spine being tested.
  2. Skin Cleaning & Numbing
    The skin is cleaned, and a small amount of local anesthetic is used to numb the area.
  3. Fluoroscopy-Guided Needle Placement
    A thin needle is guided into the center of the targeted spinal disc using live X-ray images.
  4. Injection of Contrast Dye
    A small amount of dye is injected to pressurize the disc.
    • If the disc is normal: you may feel pressure but not true pain.
    • If the disc is painful: you may feel your usual, familiar pain.
  6. Pain Mapping
    You will be asked to describe the sensation so the provider can determine whether this disc matches your everyday pain.
  7. Post-Procedure CT Scan
    In most cases, a CT scan is done afterward to evaluate how the dye spread inside the disc.

Total procedure time is typically 20–40 minutes.

What to Expect After the Procedure

  • Temporary soreness at the injection site is common.
  • Pain from the test usually improves within 24–48 hours.
  • Most patients return to normal activity the next day unless told otherwise.
  • Your provider will review the results and discuss next treatment steps.

Risks and Precautions

Discography is generally safe, but as with any procedure, there are potential risks:

  • Temporary pain or soreness
  • Bleeding
  • Infection (rare but possible, including disc infection)
  • Headache
  • Nerve irritation
  • No improvement in symptoms
    Because this procedure is diagnostic, discomfort during testing is expected and provides valuable information.

When to Call the Office

Contact your provider immediately if you experience:

  • Fever or chills
  • Increasing back pain
  • Redness, warmth, or drainage at the injection site
  • New weakness, numbness, or unusual symptoms

Key Takeaway

A discography does not treat pain—it helps identify exactly which disc is painful so your care team can make the most accurate treatment or surgical plan. It is an important step when MRI findings don’t fully explain your symptoms or when surgery is being considered.