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Methods of Back Pain Diagnosis

Back Pain Relief Information - back pain

Methods of Back Pain Diagnosis
By Brennan Howe
In order to diagnose for relief treatments, 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.

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.  The medical history delves into these areas of the person seeking pain relief: family medical history and personal and work history with regards to 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.

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 neurological 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.

For 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.

Where To Go For Pain Relief

Where to go for a diagnosis about can include your family doctor, the emergency room, an orthopedic surgeon, a naturopathic specialist, a rheumatologist , an occupational therapist, a physiotherapist, a chiropractor, an acupuncturist, a massage therapist, an osteopath and a chronic pain heath care provider.  And here is a brief overview of each.

FAMILY DOCTOR – This is a popular beginning point for many seeking back pain relief.  Although family doctors generally do not have extensive orthopedic backgrounds nor sufficient time to schedule complete histories and examinations during regular hectic weekdays, they are often able to do preliminary testing and assessment.  Their blood tests and general knowledge of your health and basic back care can help them point you to further resources and places for following up, especially if they deem the case an emergency.  And hopefully your family doctor will be at the center or helm of your pain relief management so that all testing, treatments, office visits, etc. are coordinated and not left to chance, and also so that patient care is optimized.

EMERGENCY ROOM – When a family or general doctor is not available, some symptoms may warrant an emergency room visit.  The following list of symptoms, though not limited, is what most often sends people to the emergency room for relief; a major injury or trauma, history of osteoporosis, steroid medications or cancer, severe pain, fever, aggressive or quick weight loss for no known reason.  The degree of suggested seriousness in the symptoms may determine how quickly a person is seen in the emergency room, with the more serious cases seen quicker.

Emergency room procedures can involve history and examination assessments and a series of blood, urine and other tests.  Additionally the emergency room physician may recommend a consult with a specialist while you are there.  Or they may recommend you to your family doctor or other treatment facility for follow up, depending upon their results.

ORTHOPEDIC SURGEON – Orthopedic medicine in a nutshell deals with the prevention or correction of injuries or disorders of the skeletal system and associated muscles, joints, tendons and ligaments. Surgeons in this field offer treatment for fractures, strains, arthritis, dislocations and other related problems throughout the entire body.  And their treatments vary with surgery and non-surgical health care; structure repair, joint replacement, arthroscopy or the examination and possible

treatment of the interior of a joint, like the knee, using a type of endoscope inserted into the joint through a small incision.  Likewise, they coordinate healing activities during healing and pain relief stages.  Note that some orthopedic surgeons specialize: in the area of relief, a specialist based in spinal practice may be advisable.

NATUROPATHIC SPECIALIST – Naturopathic medicine refers to natural substances or remedies massage as treatments.  Doctors in this field are educated in nutrition and herbal, botanical, homeopathic and Chinese medicines (and acupuncture).  They may also treat with hands-on procedures and lifestyle consultations where preventative measures are a focus.  These specialists may refer you to your family doctor and may also coordinate healthcare activities before, during and after your episode for overall improved wellness.  Often for relief, they may advise natural supplements like herbal medicines or minerals along with dietary modifications.  And physical therapy; acupuncture or message, combined with stress management and relaxation therapy may be added in for good measure.

RHEUMATOLOGIST – A rheumatologist deals with an array of pathological conditions like arthritis related to the tendons, muscles, joints, nerves or bones, when seeking aid for discomfort and disability.  Although some may perform arthroscopy, most do not do surgery.  For relief, they may suggest medications, occupational or injection therapy and other medical treatment to determine cause and pain relief.

OCCUPATIONAL THERAPIST – An occupational therapist emphasizes correct ergonomics or design factors, posture and safety practices both at the workplace and in the home environment.  These therapists educate patients about daily life activities and can help with adjusting to health devices for mobility and operation.  Adjusting to using crutches, a back brace, a cane and other lifestyle changes are benefits of occupational therapy.

PHYSIOTHERAPIST – Registered therapists practice physiotherapy and focus on educating and instructing patients about their pain- both in book learning and physical understanding, like with posture and movement modifications.  Their shared knowledge helps patients overcome fear and anxiety and better manage their treatment programs.  Doctors often refer patients to physiotherapists for extended learning, particularly if there is difficulty in diagnosing the cause and / or treatment for pain.  Additionally, physiotherapists help with the development and managing of their healthcare programs, activities and preventive care instruction. For example, they may teach about using heat or ice along with a varied range of motion for pain relief.

CHIROPRACTOR – In a nutshell, chiropractors diagnose spine, joint and muscle problems with their hands. And their treatment is hands-on as well.  For relief, they use mobilizations and manipulations in manual spinal movements, some known as “cracking” the back into place.  Although there is no scientific evidence to support or negate chiropractors treatment, most generally work with the relief of acute low back pain.  Besides in-office treatment, many provide exercise and preventative strategies for follow up.

ACUPUNCTURIST – Acupuncture, relating to Chinese medical practice, is the piercing of specific areas of the body with fine needles.  The reasons for acupuncture are threefold; for therapeutic purposes, to relieve pain or for regional anesthesia.  It is mainly used for musculoskeletal pain and low and other related relief.

MASSAGE THERAPIST – Massage therapy incorporates hands-on handling or manipulation of body tissues, especially helpful for low back pain relief.  The reasons for massage vary; for relief from pain and muscle spasms associated with it, for relaxation, for stretching, improved circulation and metabolism.

OSTEOPATH – Osteopaths use Osteopathic Manual Medicine (OMM) to practice medicine based on the theory that conditions in the musculoskeletal system affect other bodily parts.  These conditions cause disorders that they believe can hopefully be corrected by manipulative techniques combined with traditional medical, pharmacological, surgical and other therapeutic strategies.  Generally within 10 to 14 days, osteopathy relieves low back pain.  But there is no evidence to suggest osteopathy as preventative treatment long-term.

CHRONIC PAIN SPECIALIST – A chronic pain specialist is for rare cases and works in teams.  He or she generally manages pain relief treatment with psychiatrists, social workers and other medical and counseling healthcare providers.

The main relief treatment for chronic low is conservative intervention.  In other words, jumping into surgery is not advised because many people suffer no yet have degenerative change or aging issues going on in the back region.  And other treatment options may offer relief instead. And according to studies, there is no evidence that points to delayed surgery resulting in increased complications.  In fact approximately 80 percent of the cases where surgery was indicated as a solution recovered regardless of the surgery.  So whether or not they had it made no difference.  Really under 40 percent are reported to have benefited from surgery. And on the contrary, those people with surgical pasts reported the need for future surgeries, many because their pain actually increased with surgery.  So good medical history and physical examination preparation and assessment can go a long way in determining treatment options.

Conservative treatment would include an overall physical and psychological pain-handling program incorporated into the patient’s lifestyle.  It would education and offer training about symptom management; movement and posture strategies, physical therapy, acupuncture, epidural analgesics, pain medication and other associated issues.

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