How is back pain diagnosed?

Evaluating the patient's medical history often is the doctor's most powerful diagnostic tool. The doctor asks a series of questions to help identify possible causes of the back pain.

The questions may focus on:

  • Lifestyle factors, such as where you live, what type of work you do, and what activities or hobbies you enjoy
  • When your pain began
  • Where your pain is located and what effect it has had on your daily activities
  • Whether your pain has responded to any treatment
  • Your medical, surgical, family, and social history

Extensive testing — including X-rays, MRI/CT scans, EMGs (electromyography, to test electrical activity of skeletal muscles), and lab tests — are necessary in only a small number of cases.

For example, the MRI (magnetic resonance imaging) gives little information about the condition of the ligaments, muscles, and tendons. However, it may show common degenerative, or "wear and tear," changes in the discs or joints in the spine.

One or more of these diagnostic tests may be done immediately if the pain is caused by trauma or a neurological change, persistent fever, weight loss, numbness, weakness, or loss of bowel or bladder control.

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