So confused after discogram discussion

[Dingie]

I had my first discogram last week in prep for recommended ADR. The belief was L4-L5. Surprisingly 0 pain of any kind at that level, L3-L4 was SIG but pain although similar stayed on the right side my usual pain is more on L? So I thought the diagnosis was done L3-L4. However my US surgeon isn't sure.

Now being scheduled for disc blocks at L2-L3 and L3-L4. Here are my questions for my new ADR friends in the process. All discs from L3-L5 "leaked". L2-L3 hurt but it wasnt the worst pain and so I said not so bad. He said it is always poss bad looking discs are not painful but my L2-L3 looks like a dog,chewed on it.

My doc who knows me quite well has always said I don't recognize pain properly.
So here lies my confusion, I answered neg to pain for years to the question of leg pain because I don't generally think of aching as pain, which is what I felt on L2- L3. My surgeon almost smacked me when I said well I always have that is that a big deal? I was told to respond on the next test to ANYTHING other than nothing as pain. Does that make sense to anyone? I am so scared to get a false neg or a false pos and am driving myself and everyone else nuts.

I will say I have the gift or curse of trancing through pain and have run several triathlons on broken feet and ripped tendons..is aching considered pain to most?

Did you feel your discogram was definitive? Thanks for helping an apparent loon.

Laurie

[Jstuckey]

I can relate... I think after years of pain - some things seem "normal". I didn't know my legs cramps were nerve pain. I thought it was restless legs or just me being tired at the end of the day. Doesn't everyone have that? Now, in hind-sight, I realize that you shouldn't hurt, ache, cramp, etc. unless you just had a good workout the few days before. As far as the discogram, I felt more pressure at the sight of the injection oon the negative level - but nothing down my legs (if I remember correctly). The positive level was more dramatic and I had tears in my eyes, but I only rated it a 6 or 7 of 10. Someone else may have said a "3" and others maybe an "11" as I think perception of pain is always somewhat subjective, but the number system is about as good as it gets to describe it.
The discogram was only part of my decision process - I wouldn't say it was everything. MRI, CT, xray, history, worsening symptoms, etc all contributed to the decision.

[laid up doc]

mine was quite definitive - but there was clearly only one level.

what you describe is where which levels to "do" gets very tricky... you're going to need to talk for a good bit w/ the doc who did the discogram, and your surgeon, and maybe even get THEM to talk to figure things out.

sorry it was more clear for you!!

[Cirobi]

I can definitely relate. My discogram was on four levels starting at L5/S1 which looked the worst on my MRI. They did the other three above that because L4/L5 looked similar to L5/S1 but not quite as bad. L4/L5 was the questionable one and the one that concerns me as I get to the end of my pregnancy because the surgeon I worked with for the discogram was pretty concerned with it base on the MRI images.

The other two levels just had slight buldges and were checked just to be thorough.

I was nervous going into the discogram for the same reason you're expressing confusion. I'd dealt with increasing back pain for just over a decade by the time I had that discogram and knew that I already considered certain kinds of pain as "normal" because of that. In fact, initial discussions with the surgeon who did my discogram were difficult and I admitted that rating the pain level was often difficult because I knew I had gotten used to certain levels of pain. So, the surgeon told me to just do my best.

Thankfully, it was pretty obvious which one generated the most pain. L5/S1 definitely felt the worst of the four tested, though I don't remember it giving me the same severity of pain that I sometimes felt. Not sure if that was a side effect of laying down while the test was done. L4/L5 was sore but closer in level to the two above that were tested so it was easy for him to determine that it was still solid enough to try to preserve by replacing the lowest level only.

Hopefully through discussion with your docs a better determination can be made on what to actually replace. Don't worry though, being confused on how to rate the pain seems fairly normal. When you get used to being in pain, it's hard to break it down into levels.

Good luck with the testing and diagnosis. Hopefully you'll be on the road to recovery soon!

~Sara