[Kathy]

The facet blocks are done to see if they help your pain. If they do, then they know you have facet pain. Which is/can be caused by facet arthritis, which is an exclusion to ADR. An MRI does show arthritis; but the degree of it is debatable, depending on who is reading it. My radiology reading of my MRI said I had moderate to severe facet arthritis. All 3 of my surgeons believed it to be mild to moderate. They also believed this because I had had facet blocks and they did not help. Which led them to believe my pain was coming from my disc.

On to discograms, I have had 2. The first one was pretty painful and I was given very little medication, as they want you to be alert to tell them if it hurts or not. The second one was wonderful. I was sedated while all the needles were inserted, woken up, asked the does it hurt questions and then sedated again. This really depends on who does your discogram, if they will give you sedation or not.
What happens during the discogram? They inject some 'control' discs (ie. good discs, not believed to be causing pain). They ask you what you feel, generally on a good disc you will feel pressure; but no pain. They then inject 'bad' discs (the disc or discs believed to be causing pain). They ask what you feel, usually if the disc is the pain source, this will re-create your usual pain. They don't tell you which disc they are injecting and don't do it in any order, to make sure you don't know. The theory is that the bad discs will cause pain and the good discs won't. They can also see the dye, is the disc holding it? Is it leaking out rapidly? How much dye did they have to inject? And more that I don't know.

I have heard it said that they are not foolproof and not that good of a diagnostic. It worked for me, both showed my L4/5 as painful and re-created my pain exactly. Some people have a myleogram instead or in addition to a discogram. I don't know what a myleogram does, so maybe someone else can explain that.