Procedure

Pain Blocks & Discography

Pain blocks and discography are precision-guided procedures that both diagnose the exact source of spinal pain and deliver targeted relief — eliminating guesswork in complex spinal pain management.

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Overview

About This Procedure

Discography involves injecting contrast dye into a suspected painful disc to reproduce and confirm the patient's pain pattern — definitively identifying discogenic pain before surgical intervention. Pain blocks include medial branch blocks (for facet joint pain), selective nerve root blocks, sacroiliac joint blocks, and sympathetic ganglion blocks. These procedures are performed under fluoroscopic guidance with real-time contrast confirmation, ensuring the medication reaches the precise anatomical target. Dr. Sparsh Jaiswal performs all pain blocks in a dedicated procedure suite with full monitoring.

Indications

check_circleChronic back pain unresponsive to 4–6 months of conservative management
check_circleIdentifying the painful disc level before surgical fusion (discography)
check_circleDiagnosing facet-mediated pain versus discogenic pain
check_circleSacroiliac joint dysfunction causing low back and buttock pain
check_circleRadicular pain from nerve root compression

Step-by-Step Procedure

Pre-procedure Assessment

Review of imaging, pain mapping, and VAS scoring. IV access, consent, and monitoring established. Patient positioned on the fluoroscopy table.

Fluoroscopic Localisation

C-arm fluoroscopy identifies the target disc, joint, or nerve. Skin marked and sterilised with antiseptic. Local anaesthesia infiltrated at the entry site.

Needle Placement

A fine-gauge needle is advanced under continuous fluoroscopic guidance. Contrast injection confirms correct placement within the target structure.

Drug Delivery / Provocative Testing

For therapeutic blocks: steroid ± local anaesthetic injected. For discography: saline/contrast injected to provoke concordant pain. Results documented immediately.

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What to Expect

The procedure takes 20–40 minutes. You will be awake throughout to provide feedback. Mild soreness at the needle entry site is normal for 24–48 hours. Therapeutic blocks typically produce significant pain relief within 48–72 hours.

healing

Recovery

Rest for the remainder of the day after the procedure. Light activities can resume the next day. Avoid driving for 24 hours if sedation was used. Pain diary for 2 weeks helps assess response.