Doctors usually diagnose back pain on the basis of the medical history, physical examination and sometimes imaging and lab test. The purpose of diagnostic procedures is to check for abnormalities of the spine. Determining the underlying problems that have been causing your discomfort is the key towards better management of your back pain.
In medical history taking, your doctor will look into some information that will help identify the cause of your back pain. You should expect to be asked about any other medical conditions you may have now or had in the past, as well as diseases that run in your family. Your doctor will also ask you about your symptoms, these include the location and intensity of pain, when does it usually occur, what relieves the pain and what makes it worse, how your discomfort affects your normal functioning, and more.
There are also questions that pertain to psychological problems such as depression. Psychological factors have been linked to the onset of back pain and the development of chronic back pain; therefore, questions about it are included in the medical history.
It is important disclose all information about present condition past medical history with your doctor. The details of your medical history will be used as a guideline in planning treatment.
The physical exam is used by your doctor to follow up on the information gathered from your medical history. It is needed to confirm or rule out a diagnosis. Physical examination involves tests to assess restriction of movement which will help in locating the specific source of pain.
Your doctor will ask you to do a series of movements while you stand, sit, and lie down. This would allow him to assess your muscle strength, range of motion and reflexes.
Sometimes medical history and physical examination are not enough to identify the underlying problem, for this reason, your doctor may order diagnostic procedures to rule out certain conditions. If your doctor suspects problems such as fracture, tumor, infection any other conditions to be causing your back pain, imaging and electro diagnostic tests may be needed to confirm the diagnosis.
X-ray examination is a painless diagnostic procedure which uses electromagnetic radiations to take images of your bones and internal organs. Your doctor will use it to check the alignment of your spine. X-ray images help in determining whether your bone is dislocated or broken. X-ray helps in evaluating bone injuries, joint infections and progression of degenerative conditions like osteoporosis and arthritis. The problems in the spinal cord, muscles, nerves or disk won't be seen directly from X-ray images.
Magnetic resonance imaging (MRI)
Magnetic resonance imaging (MRI) of the spine is a painless test that uses a magnetic field and radio waves to produce detailed pictures of the bones,muscles, nerves, ligaments and blood vessels in your back. An MRI scanner has a large doughnut-shaped magnet that has a tunnel in the center. MRI is very important in diagnosing the cause of back pain. It produces cross-sectional, black and white images, which help to pinpoint problems in the spine. MRI can detect a variety of conditions of the spine. It can be useful in evaluating symptoms of back pain and nerve-related problems such as leg pain, numbness, tingling or weakness, or problems with bladder and bowel control. It can also help to rule out or confirm presence tumors, bleeding, swelling, structural irregularities, and infections or inflammation in the vertebrae or surrounding tissues.
Bone Scan involves injecting a small quantity of radioactive substance into the patient's vein. The injected material travels through the blood stream and settles in the bone's problem areas, particularly on damaged sites or where there are abnormal bone formation. During the test, the patient lies still on a table and the scanner passes back and forth across the body. A bone scan can detect possibility of conditions such as tumor, infection, arthritis, fracture, and joint problems.
Nerve studies (electromyography, or EMG)
An electromyogram (EMG) is a test that records your muscle's electrical activity. For this procedure, needle electrodes are inserted into the muscle tissue, this will trigger an electrical activity, which will then be measured to determine a baseline. You will be then asked to to flex and relax your muscle. The resulting current is recorded on an electromyograph and will be analyzed by your doctor. EMG can help distinguish between muscle conditions that are caused by the muscles themselves, and weaknesses that result from certain nerve disorders. EMG is useful in evaluating symptoms such as arm weakness, cramping, numbness and pain.
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