Diagnosing Back Pain
Your surgeon will evaluate your health history, perform a physical examination, test nerve function, and radiological tests to diagnose your back pain.
- Medical history
- Examine affected joint
- Range of motion tests
- Joint-line tenderness
- Joint deformities
- Test nerve function
- Radiological Tests
X-rays reveal problems with bones, such as infections, tumors, or fractures. They can also give your doctor information about how much degeneration has already occurred in the spine. X-rays are most often the first test ordered before any of the more specialized tests.
Flexion and Extension X-rays
Flexion and extension x-rays may help to determine if there is instability between any of the vertebrae in the spine. These x-rays are taken from the side as you first lean far forward and then far backward. The doctor then compares the two x-rays to see how much motion occurs between each spinal segment.
The MRI scan uses magnetic waves to make pictures of the lumbar spine in slices. The scan shows the lumbar bones as well as the soft tissue structures like the discs, joints, and nerves. The MRI is the most common test to look at the lumbar spine after x-rays have been taken.
The CT scan is a type of x-ray that allows doctors to see slices of bone tissue created by a computer and x-rays. It is primarily used when there are suspected bone problems.
The myelogram is a type of x-ray test where a dye is injected into the spinal sac. It helps a doctor see if there is a herniated disc, pressure on the spinal cord or spinal nerves, or a spinal tumor. The myelogram is usually used in combination with the CT scan to give more detail; however, it is used less often than the other tests.
A bone scan is a test in which radioactive tracers are injected into the blood stream. The tracers then show up on an x-rays of your back. These tracers build up in areas where bone is undergoing a repair process, such as a healing fracture or the area surrounding an infection. Most often the bone scan is used to locate the problem.
You should discuss your condition and treatment options with your surgeon.
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