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How do Doctors Make a Back Pain Diagnosis?

M. DePietro
M. DePietro

Back pain is a very common complaint among adults. There are so many causes of back pain, it may take a process of elimination to get to the cause of the problem. In order to make a back pain diagnosis, a physician may do a variety of tests and complete a physical exam and medical history. Making an accurate back pain diagnosis is essential to getting effective treatment.

Determining the cause of back pain can be difficult in some cases. A detailed medical history and a physical are often the first step in back pain diagnosis. The physician will also ask about the type of pain. For instance, some people may have tingling back pain or radiating back pain.

Ice packs can help with lower back pain.
Ice packs can help with lower back pain.

The physician may ask when the pain started and how severe it is. Understanding the type of pain helps in making a back pain diagnosis. It’s also important to determine if a person is suffering from chronic back pain, which means it has been occurring for a while. Another classification is acute back pain, which means it has developed suddenly.

A physical exam will than be performed to check for any spinal abnormalities. A person’s reflexes will be checked. The physician will also test to determine if strength or range of motion has decreased. After an exam and medical history, various tests may be ordered, starting with an x-ray. An x-ray will take a picture of the bones in the back and may help determine if there are any fractures or tumors on the spine.

Medical tests and a physical exam can help diagnose back pain.
Medical tests and a physical exam can help diagnose back pain.

Often, a CT scan can provide more detail than an x-ray and may be needed in some cases. Another tool to help a doctor make a back pain diagnosis is a magnetic resonance imaging scan (MRI). The MRI uses magnets to produce images of the body. Because an MRI can create images from varied planes, it is sometimes helpful in determining the cause of back pain. It is important to note that an MRI can fail to detect ruptured spinal discs about 20 percent of the time.

An MRI is used for a back pain diagnosis.
An MRI is used for a back pain diagnosis.

Myelogram is one more diagnostic tool doctors use to determine the cause of back pain. It is a special type of x-ray using a dye injected into the spine. Although it was common in the past, it is not used as often now that magnetic resonance imaging is available. It still may be used with a CT scan in certain situations to help diagnose back pain. It is most often done if back surgery will be needed.

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    • Ice packs can help with lower back pain.
      By: Kimberly Reinick
      Ice packs can help with lower back pain.
    • Medical tests and a physical exam can help diagnose back pain.
      By: mangostock
      Medical tests and a physical exam can help diagnose back pain.
    • An MRI is used for a back pain diagnosis.
      By: Andrey Navrotskiy
      An MRI is used for a back pain diagnosis.
    • To diagnose pain, a doctor will perform a physical exam, including a test of the patient's reflexes.
      By: Protosom
      To diagnose pain, a doctor will perform a physical exam, including a test of the patient's reflexes.
    • Spinal cord problems can cause a loss of reflexes in the body.
      By: Jürgen Fälchle
      Spinal cord problems can cause a loss of reflexes in the body.
    • X-rays allow doctors to see the bones of the back.
      By: Lisa F. Young
      X-rays allow doctors to see the bones of the back.
    • The diagnosis of a herniated disc and many other spinal issues are most commonly confirmed using an MRI.
      By: EPSTOCK
      The diagnosis of a herniated disc and many other spinal issues are most commonly confirmed using an MRI.