Diagnosis and Tests for Back Pain


There are many causes of back pain which your doctor can determine. A medical checkup will let your doctor discover the origin of the pain and what caused it.
When you visit the clinic of your doctor, they will usually begin the workup with a physical assessment and a detailed health history. Your doctor may give you some simple tests for flexibility and muscle strength. They will also examine your back and your ability to sit, stand, bend, twist, turn, walk, and lift your legs.

Often, medical health history and a physical examination are not enough to help the doctor identify the cause of your back pain. If your doctor suspects that there is a significant underlying cause, like a fracture, tumor, infection, or any other specific health condition, they may order one or more tests.

These tests may include:

Blood and Urine Tests:
These tests may help your doctor pinpoint the presence of an infection or inflammation. If there is an infection, antibiotics may be needed.

This test is the primary diagnostic testing method that your doctor will order. X-rays will show the alignment of your bones and the spaces between bones. X-rays can’t provide information if you have any problems with your muscles, spinal cord, nerves, and discs. X-rays can show if you have arthritis or any broken bones.

MRI (Magnetic Resonance Imaging):
This diagnostic test uses a magnetic field and radio waves to generate highly detailed images of anatomic areas inside your body. As x-rays will only show bones, an MRI may be ordered by your doctor as an additional diagnostic test to determine the cause of your back pain. The MRI will reveal any problems like herniated discs, or problems that involve muscles, tendons, bones, nerves, ligaments, soft tissues, and blood vessels. An MRI is very safe and pain-free, but can be expensive.

CT scan/Myelogram:
A CT scan is similar to an MRI. It can provide additional detailed information about the internal structures of the spine. A myelogram can diagnose a bulging disc, tumor, or any changes in the bone that surrounds the spinal cord or nerves. This involves injecting local anesthetic into the back to numb the area. A lumbar puncture is then done and a dye is injected into the spinal canal to reveal where the problem lies.

Bone Scan:
Rarely, your doctor may order a bone scan. This will help the doctor to determine the presence of bone tumors, or any compressions fractures brought about by osteoporosis.

Nerves Studies (EMG or electromyography):
This diagnostic test measures the electrical impulses created by the nerves and the responses of your muscles. This test studies the nerve conduction pathways to confirm nerve compression caused by herniated discs and spinal stenosis.

This test will determine the internal structure of your discs. It is performed, under local anesthesia, by injecting a dye into the disc under x-ray guidance. An x-ray or CT scan is done to determine if the disc’s structure is normal or abnormal, and if the injection is causing pain. This enables the spine surgeon to determine the disc level that may be causing your back pain.

Sound complex? Well it can be, and that is why it is important to be as specific about your symptoms as possible so that the cause of your back pain can be swiftly taken care of.