Procedure Description
A provocation discogram, also called discography, is a diagnostic procedure used to identify whether one or more intervertebral discs are the source of a patient’s chronic back pain. Unlike an MRI or CT scan, which shows anatomical detail, a discogram evaluates disc function and pain response by injecting contrast dye into the disc under pressure to provoke symptoms.
This test is typically used prior to spine surgery or interventional procedures, when imaging alone is not sufficient to pinpoint the cause of pain.
What It Treats
While a discogram does not treat pain, it helps diagnose the source of chronic back or neck pain and guides treatment decisions. It is useful for patients with:
Chronic low back or neck pain not explained by MRI or CT scans
Suspected discogenic pain (pain originating from spinal discs)
Post-surgical spinal pain (to determine new or persistent pain sources)
Pre-surgical planning for spinal fusion or disc replacement
Multiple disc abnormalities on imaging where targeted treatment decisions are needed
How It Is Performed
The patient is positioned on a procedure table (typically face down for lumbar or sitting for cervical discograms).
The skin is cleansed and numbed with local anesthetic.
Under fluoroscopic (X-ray) guidance, a thin needle is inserted into the center of the disc(s) being evaluated.
Contrast dye is injected into each disc under controlled pressure:
If the disc is normal, there is no or minimal pain.
If the disc is damaged or degenerated, it may reproduce the patient’s typical pain ("provoked" pain).
The spread of the dye is recorded on fluoroscopic images, and in some cases, a post-discogram CT scan is performed for detailed evaluation.
The procedure typically takes 30–60 minutes, depending on how many discs are tested.
Pre-Procedure Instructions
Do not eat or drink for at least 6 hours before the procedure.
Arrange for a responsible adult to drive you home after the procedure.
Continue most medications unless advised otherwise; you may need to pause blood thinners several days in advance—follow your doctor’s instructions.
Inform your provider if you:
Are allergic to iodine, contrast dye, or antibiotics
Are pregnant or suspect pregnancy
Have a current infection or fever
What to Expect After the Procedure
Mild back soreness is common for 1–3 days; ice packs and over-the-counter medications can help.
You may feel transient pain that mimics your usual symptoms—this is expected if the disc is a source of your pain.
Avoid heavy lifting, strenuous activity, or driving for 24 hours.
Your physician will review the discogram and correlate it with imaging and clinical findings to determine if surgery or other interventions are appropriate.
In some cases, a post-discogram CT scan is scheduled shortly after the procedure for further analysis.
Call your provider if you experience:
Fever, chills, or signs of infection
Worsening back pain or new leg symptoms
Persistent headache or nausea
Precision Diagnosis for Personalized Spine Treatment
At Parkview Spine & Pain, we use advanced imaging and diagnostic procedures like provocation discograms to accurately identify the source of spine pain. This allows for tailored treatment plans—whether surgical or non-surgical—for long-term relief.
👉 Schedule your consultation today to determine whether a discogram can help identify the source of your back or neck pain.