Low Back Pain
(Part 4)
Tests and Diagnosis for Lower Back Pain
Medical History and Physical Examination
After discussing your symptoms and medical history, your doctor will examine your back. This may include:
∙ Looking at your back and pushing on different areas to see if it hurts.
∙ Having you bend forward, backward, and side to side to look for limitations or pain.
∙ Measuring the nerve function in your legs by checking your reflexes at your knees and ankles, as well as testing strength and sensation. This might tell your doctor if the nerves are seriously affected.
Imaging Tests
Other tests which may help your doctor determine your diagnosis include:
X-rays. X-rays can help determine if you have the most obvious causes of back pain. They will show broken bones, aging changes, curves, or deformities. X-rays do not show disks, muscles, or nerves.
Magnetic resonance imaging (MRI). MRI scans show the soft tissues, such as muscles, nerves, and spinal disks, as well as the bones and joints. Conditions such as a herniated disk or an infection are more visible on an MRI scan.
Treatment
Computerized axial tomography (CT) scans. If your doctor suspects a bone problem, they may suggest a CT scan. This study is like a three-dimensional X-ray and focuses on the bones.
Bone scan. Your doctor may suggest a bone scan if they need more information to evaluate your pain and to make sure that the pain is not from a rare problem like cancer or an infection. A bone scan can also help detect a fracture.
Bone density test. If osteoporosis is a concern, your doctor may order a bone density test.
Osteoporosis weakens bone and makes it more likely to break. Osteoporosis by itself should not cause back pain, but spinal fractures due to osteoporosis can. (To be continued)