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All in your Head or in your Back?
Back Pain Diagnosis
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In order to diagnose back pain for treatment, generally health care professional begin by ordering a medical history and physical examination. A look at each of these in depth can shed some light into what to look for and how to find relief from pain. Then we’ll look at specific diagnostic tests. And then where to go for the diagnosis and testing follows.
Medical History
No matter whether the patient has acute back pain, which is what most have and recover from with around a 4-week period, or chronic, recurring pain episodes, a medical history helps patient an doctor become familiar with one another in confidence to begin or continue a treatment program together.
A through medical history is rare in the medical system today. A complete medical history delves into these areas of the person seeking pain relief: family medical history and personal and work history with regards to back pain episodes and related symptoms and issues, psychological and psychosocial factors, referral source(s) for evaluation and treatment, education on the subject and treatment options, assessment throughout their working together on pain relief treatment and treatment outcomes. For example, if physical therapy needs to be added to the regimen or enhanced, it would be discussed in the medical history and updated as needed.
The medical history incorporates past and present factors of fatigue, fever and weight loss. And it notes any use of drugs or herbs, minerals and supplements. A history of past and present infections, cancer or other conditions is also noted.
The history also includes details about the back pain, focusing on the many facets of the pain: information about any initial injury or trauma, if available, onset, intensity, duration, location, associated symptoms, etc.
Physical Examination
The physical examination includes evaluating the person generally inn the “hospital gown” with the body and especially the back in a variety of postures and movement ranges to determine pain symptoms, tenderness and range of motion. So the patient may need to sit, stand, touch toes, move arms, etc. and share any pain symptoms or other information notated with each change along the way.
Neurological testing can also be a part of the routine. A neurologic screening may consist of tests for reflexes, strength of muscles, cramping and a detailed look at sensory issues via various range of motion and movement exercises. Included in this can be an assessment of the legs, upper leg, hip and groin area and pulses for neurological and vascular conditions.
Results may point to a secondary problem like kidney stones or a slight bone fracture, for instance, in which cases, further assessment and treatment options would be considered and discussed in both the medical history and physical examination.
Noteworthy is that patients seeking relief after an extended period can tend to exaggerate or magnify their symptoms out of a variety of reasons; possibly psychological factors associated with fear of the unknown, change, coping alternatives, insurance coverage and treatment costs, previous visits with health care providers, etc. So education and patience is advised to that all bases can be covered, i.e. so that effective pain relief remedies can be determined.
Diagnostic Testing
For back pain relief, any of several tests can be performed; x-rays or radiographs, isotope bone scan (referred to as technetium and SPECT), magnetic resonance imaging (MRI), computerized axial tomography (CAT) scan, myelogram, blood and nerve tests and injections.
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To Find out about which types of health practitioners have a role in
the treatment of back pain come back next week for our article on What
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