• Sciatica
• Herniated Disc
• Spinal Stenosis
• Degenerative Disc Disease
• Facet Syndrome
• Sacroiliac Joint Syndrome
• Spinal Cord Stimulation

Degenerative Disc Disease
The vertebrae of the spinal column are separated from each other by cartilaginous cushions known as intervertebral discs. The discs provide structural support to the spine and act as shock absorbers, taking in the stress created by movement. The discs are mostly water, allowing them to be very elastic and absorb stress. However, age, repetitive strain, and genetics cause disc wear and tear. Because there is little blood supply to the disc, it cannot repair itself if injured.

Degenerative disc disease can produce pain as a worn disc becomes thin, narrowing the space between the vertebrae. With less space available, nerves may become compressed, causing them to swell and signal pain. Pieces of the damaged disc may also break off and cause irritation of the nerves. As the disc loses its ability to absorb stress and provide support, other parts of the spine become overloaded, thus leading to irritation, inflammation, fatigue, muscle spasms, and back pain.

Discograms
Lumbar Discography is an injection technique used to evaluate patients with back pain who have not responded to extensive conservative care regimens. The most common use of discography is for surgical planning prior to a lumbar fusion.

Lumbar discography is considered for patients who, despite extensive conservative treatment, have disabling low back pain, groin pain, hip pain, and/or leg pain. When a variety of spinal diagnostic procedures have failed to elucidate the primary pain generator, these individuals may benefit from lumbar discography especially if spinal surgery is contemplated.

It should be understood that the discogram is less about what the disc looks like and more about determining if the disc is painful. A really abnormal looking disc may not be painful and a minimally disrupted disc may be associated with severe pain. It is impossible to definitively diagnose a painful disc without performing a discogram.

A discogram procedure involved placing needles into several discs including one which is felt to be "normal" and then pressurizing the disc by injecting x-ray dye. The goal of this pressurization is to reproduce the patient's pain from the painful disc. During the procedure, the physiatrist with be talking to you to find out what, if any, symptoms may be elicited. Patients need to understand that this is a painful but necessary step in the diagnostic work up in order confirm the source of their symptoms and hopefully eventually provide the best surgical treatment.