Blocks involve the precise placement of local anesthetic or numbing medication in or near the presumed painful structure such as the zygapophyseal or facet joints or spinal nerve.
The patient’s pain is assessed both before and after the block and inferences can be made regarding the “pain generator” or exact structure causing the pain. Only when a definitive diagnosis of the pain generator is made can your physician make more appropriate recommendations for treatment of the painful condition and offer a prognosis for improvement.
It should be understood that the discogram is less about the anatomy of the disc (what the disc looks like) and more about its physiology (determining if the disc is painful).
It is well known to discographers that a really abnormal looking disc may not be painful and a minimally disrupted disc may be associated with severe pain. It is impossible to definitively diagnose a painful disc without performing a discogram.