Back pain or neck pain can be the result of many abnormalities affecting the joints in the spine (called facets), the discs, ligaments, and muscles. How do you know where the pain is coming from? Many high-quality studies show that a neurological or an orthopedic exam can find the source of pain in less than 50% of cases. Similarly, an MRI exam shows a very poor correlation between the abnormalities in the images and the source of the pain. For example, half of the normal population without pain has at least two disc herniations. At our clinics, we pursued specialized sophisticated testing to unveil the cause of your pain and use micro procedures to treat it. One example of many is a discogram, also called provocative discography. It is a diagnostic test used to evaluate if a disc is the source of back pain. Contrast is injected into discs at specific pressures. If a disc is the source of the pain, similar back pain is elicited at low pressures. Thus, a discogram helps determine if a specific abnormal disk in the spine is the cause of the pain. If we find that an abnormal disc causes the patient's back pain, we may inject platelet rich plasma or PRP (others inject stem cells) which may decrease pain in about 50% of patients. If this fails and the pain is severe, the patient may be a candidate for a fusion. Thus, we can avoid up to half of the surgeries with our techniques. In this illustration, Dr. Pappolla is performing a discogram at the TMC. Call for information.
