Although magnetic resonance imaging (MRI) is a very good tool for showing disc abnormalities, it does not allow your health care provider to directly determine if the abnormalities are causing your pain. Studies in which MRI was performed in people without back pain show that 35% to 52% of these patients had one or more abnormal discs. In a study of people without back pain but who were of the same age and occupation as a group of back pain patients, 76% had abnormal MRIs. These studies raise the question: If MRI shows that a back pain patient has an abnormal disc, is that abnormality related to the pain or just an abnormality similar to that seen in people without pain?
Discography is a very specific tool that may help your health care provider determine if the abnormal disc is causing your pain. Due to conflicting data on the benefits of discography, the use of discography is controversial among spine care physicians. However, many health care providers do find it is helpful in identifying the source of pain. Because discography is an invasive procedure (it involves putting needles into the disc), it is not performed early in the diagnostic and treatment process. Generally, patients who undergo discography have not gotten satisfactory pain relief from nonoperative measures such as medication, physical therapy and modified activities. They usually have had back pain for at least 4 to 6 months.
Discography is usually used in patients who are being evaluated to determine a specific cause of pain so a new treatment plan (possibly including surgery) can be developed.