In order to diagnose the cause of back pain, a doctor usually obtains a complete medical history from the patient and performs a physical exam. Then, medical tests can be ordered to get a clearer picture of what is happening inside the body that may result in back pain.
To get a thorough medical history that may give some insight as to why a patient is experiencing back pain, a doctor will probe with relevant questions that may pertain to the following:
- A possible injury or fall recently that may have resulted in back pain
- If laying down aggravates or alleviates the pain
- Positions or activities that worsen or lessen the back pain
- Times of the day when the pain is at its best and worst
- Family history of arthritis or disease that may cause spine abnormalities
- History of back pain
- History of back surgery
- Occurrence of pain, tingling, or numbness down the legs
A complete physical examination may include the following:
- The patient may be asked to stand and walk so the doctor can observe alignment and gait.
- The doctor may check a patient’s reflexes, because either diminished or heightened reflexes can be a sign of neural problems.
- Applying pressure to different spots of the back is commonly done to check for fibromyalgia. If tender points are present, that may be the cause of the back pain.
- The doctor may also check for sensation and strength of the muscles.
- Lastly, the doctor may check for indications of damage to the nerve root.
Medical tests may also be necessary to diagnose the cause of back pain. The most common test ordered is an X-Ray. Low levels of radiation are all that is needed to capture an image on film in a standard X-Ray. Electronic imaging is a more up-to-date method that is also used. Regardless, X-Rays allow the doctor to examine the bones in the body. Reasons why a doctor may order an X-Ray as a tool to diagnose back pain is if he suspects that there is a misalignment of the spine, a fracture, or presence of osteoarthritis.
A Magnetic Resonance Imaging test, or MRI, uses an intense magnetic force rather than radiation to create an image of the body. It shows clear pictures of soft tissues including ligaments, blood vessels, and tendons. A doctor may order an MRI to diagnose the cause of back pain is if there is a possibility that it is a result of infection, inflammation, tumor, or nerve pressure.
Computed Tomography, or CT scan, permits a doctor to examine spinal structures that cannot be captured by x-ray. A CT scan is a three-dimensional image of the body created by a computer out of two-dimensional pictures. A doctor may order a CT scan if he suspects that the cause of back pain may be a tumor, spinal stenosis, or herniated disc.
A less common test that a doctor may order to diagnose the cause of back pain is a blood test. He may want to see the results of a complete blood count, or CBC, which could reveal infection or inflammation in a patient. An erythrocyte sedimentation (sed) rate can also an elevated level of inflammation that would be present if there is an infection, arthritis, or tumor in the patient.
Medical tests alone are not always successful in diagnosing the cause of back pain. Even if a person is not experiencing any discomfort, there is a good chance that an MRI, x-ray, or CT scan would show some sort of abnormality. Likewise, people with no health issues and no pain may have high sed rates. Combining these tests with a medical history and physical exam is the best way to increase the chances that a doctor can accurately diagnose the cause of back pain. Even then, the exact source of the back pain is in many instances never found. However, many people find that back pain can be reduces even if the exact cause cannot be discovered.