By Mr Ahmed-Ramadan Sadek, Neurosurgeon · Last reviewed October 2026 · 6 min read

Why might I need discography?

Many people with persistent low back pain have an MRI scan that shows some disc changes: thinning, small bulges or tears in the outer wall. The difficulty is that these changes are extremely common, even in people with no pain at all. A disc that looks badly worn may be painless, while one that looks almost normal can be the real culprit.

Pain that comes from the disc itself is called discogenic pain. Discography is a way of testing a disc directly to see whether it is responsible. It is usually considered only when disabling back pain has continued despite thorough non-surgical treatment, such as physiotherapy, medicines and pain management programmes.

The most common reason for the test is planning for an operation such as a lumbar interbody fusion, in which a painful disc is removed and the vertebrae on either side are joined together. Before undertaking such a significant operation, your surgeon wants to be as sure as possible that the correct disc is being targeted.

A little anatomy

Each intervertebral disc sits between two vertebrae, holding the bones apart and soaking up jolts. It has a soft, jelly-like core (the nucleus pulposus) held inside a tough, layered outer ring (the annulus fibrosus).

With age the disc loses water and springiness (see degenerative disc disease). The outer ring can weaken or tear, and in some people the core bulges outwards, which may cause a slipped disc. Inflammation from these changes can produce pain in the back, groin, hips or legs.

Before the test

• Tell your team if you take blood-thinning medicines such as warfarin, rivaroxaban or clopidogrel, as these may need to be stopped beforehand.
• Mention any allergies, especially to X-ray contrast dye or local anaesthetic.
• Let them know if you have chronic kidney disease, because the dye can affect kidney function.
• Mention any flare-up of eczema, psoriasis or another rash affecting your back.
• Arrange for an adult to take you home and stay with you overnight if you are having sedation or a general anaesthetic.

What happens on the day

Discography is normally done as a day case. You will usually have sedation together with local anaesthetic to numb the skin; occasionally a general anaesthetic is advised.

1. You lie on your front or side and your lower back is wiped with antiseptic.
2. Using X-ray guidance, the doctor steers a fine needle into the middle of the disc being tested.
3. A small amount of contrast dye, which shows up on X-ray, is injected. Images taken from the back and the side show how the dye spreads within the disc.
4. Once the needle position in the suspected disc is confirmed, local anaesthetic is injected into it.

The local anaesthetic may numb the area for a few hours. Some people notice increased back or leg discomfort when it wears off; the nurses can give you pain relief for this.

The pain diary

You will be asked to record your pain levels over the following few days. If the anaesthetic placed in the disc noticeably reduces your usual pain, that points towards the disc being the source. Bring the diary to your follow-up appointment, where your surgeon will go through the findings and talk about suitable treatment, including whether surgery is likely to help.

Carry on with your usual pain medicines unless you feel they are no longer needed. Medicines such as morphine, gabapentin, pregabalin or amitriptyline should never be stopped abruptly; reduce them gradually with your GP’s advice.

Recovery and going home

• After a short spell in recovery, where your pulse and blood pressure are checked, you return to the ward and can get up once fully awake.
• Most people go home within a couple of hours.
• The British Association of Spine Surgeons (BASS) advises not driving for 48 hours after sedation or general anaesthetic.
• You may wish to rest from work the following day, or longer if your pain is troublesome.

Risks and complications

The BASS discography booklet describes the procedure as carrying very few risks and gives no numerical rates. The most common side effect is a temporary increase in discomfort. Less common problems are summarised below.

Risk	What it means
Temporary increased pain	The most common side effect; usually settles within days.
Bleeding	Very uncommon; more likely if you take blood thinners.
Disc infection (discitis)	Very uncommon, but can be serious and difficult to treat. Inflamed or broken skin on the back increases the risk.
Dural puncture	The needle may nick the membrane around the nerves, letting spinal fluid leak and causing a headache on standing for a few days. Lying flat usually helps.
Allergic reaction	To the dye or other medicines used.
Kidney problems	In people with chronic kidney disease, the dye can affect kidney function and, in rare cases, lead to kidney failure.
Inconclusive test	Bony overgrowth or a very narrow disc space can make it hard to place the needle, which may limit the result.

Is discography right for me?

Discography is only one piece of the puzzle. Your surgeon will interpret the result alongside your symptoms, examination and scans. It is worth asking how the result will change your treatment plan before agreeing to the test.

When to get help afterwards

Contact your hospital team or GP promptly if, in the days or weeks after the procedure, you develop increasing back pain with a fever or feel generally unwell, as this can be a sign of disc infection. Also seek advice for a headache on standing that does not settle, or redness or discharge at the needle site.

• BASS patient booklet: Lumbar Discography
• Spinemathema: Degenerative disc disease
• Spinemathema: Lumbar spinal fusion

This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist.