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Methods of Back Pain Diagnosis
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
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