Diagnosing Your Condition:

Clinical Examination:

The exam will probably begin with a medical history during which the practitioner will ask about your symptoms, your lifestyle, and about how the pain affects your daily life. This will help the doctor assess the contribution stress and lifestyle factors make to your pain. If this is your first visit, the doctor will also ask about your other medical conditions and about any surgeries you have had.

The practitioner will examine your neck and/or back and will check your ability to sit, stand, walk, and lift your arms or legs. He/she will also assess sensation (what you feel and how you feel it) and the strength of the reflexes in various parts of your body. This will help determine where the pain originates from (which is not always the same place where you feel the pain), what degree of pain-free motion you have, and whether you have muscle spasms. It will also help rule out a more serious underlying condition as the cause of the pain.

Based on the findings of the clinical examination, the practitioner may recommend some diagnostic tests. The most common ones are:

Xray

Computed Tomography (CT Scan.)

Myelogram

Magnetic Resonance Imaging (MRI)

Electromyogram (EMG)

After the clinical examination and the diagnostic studies, the doctor may determine the best way to treat your pain or may refer you to a specialist (such as an orthopaedist or neurologist), a physical therapist, or a chiropractor for further evaluation and treatment.
If you do not understand what is being explained to you, don’t be afraid to ask for clarification. It is important for you to understand your back pain so you will be better able to make informed choices and to cope with your pain.

Diagnostic Tests For Back Pain:

X–ray imaging can create detailed images of different types of tissues. For example, an x–ray of the spine can show the vertebrae and the central nervous system. It can detect fractures, infections, dislocations, tumours, bone spurs, and disc disease and help doctors evaluate spinal curvature and defects. However, not all spinal injuries can be seen on x–rays, so doctors sometimes recommend other tests such as a CT scan, MRI, or myelogram to provide more information about the structures in the back.

CT (computed tomography) scan—sometimes referred to as a CAT scan—can show the size and shape of the spinal canal, its contents, and the structures around it. A CT scan is especially helpful for showing bone detail, including stenosis. Sometimes a CT scan is done in combination with a myelogram of the spine to provide additional information.

Myelogram is a type of x–ray study that uses a special dye to make the spinal canal and nerve roots clearer. After the area is numbed with a local anaesthetic, a thin needle is used to inject the dye into the subarachnoid space (the fluid-filled space between the bones in the spinal column). It is sometimes used when other tests, such as a CT scan or MRI, do not detect the cause of the pain.

Magnetic resonance imaging (MRI) produces a three-dimensional image of body structures using powerful magnets and computer technology. It can show the spinal cord, nerve roots, and surrounding areas and can identify tumours and areas of enlargement or degeneration.

EMG (electromyogram) measures the electrical impulses in a muscle when it is at rest and when it contracts. This allows doctors to diagnose problems that damage muscles, nerves, and the places where nerves and muscles meet. Herniated disc is one of these problems. This test involves the placement of an electrode into a muscle. A wire connects the electrode to a machine that records the electrical activity in that muscle.