Discectomy best relieves sciatica leg pain. Back pain may be relieved after discectomy but it is not as consistent as leg pain. Patients with degenerate disk disease and primarily back pain may undergo a discogram (pain mapping of the disks) to confirm the symptomatic disk. Discogram helps determine if surgery will work.
Discogram is an injection into disks. If the injection produces your typical back pain (concordant pain) then this disk is most likely culprit of the back pain. In addition to pain the discogram often shows leakage of dye out of the disk through a rip called an annular tear. If the injection only causes mild pain or not typical pain then that disk is not causing the pain. In this circumstance the patient would require additional pain mapping to identify the pain source.
The treatment options to fix painful disk include endoscopic discectomy and annuloplasty (the annular tear is isolated and burned with radiofrequency coagulation) or endoscopic fusion surgery (ELIF). Often endoscopic discectomy is considered first to try to avoid fusion surgery. Unfortunately surgery does not always relieve back pain from degenerated herniated disks. Surgery should be considered the last option or not an option is some cases. Please call and set up an appointment with Dr. Carl Spivak to discuss your back. Good Luck!