Back Pain: Symptoms, Diagnosis, Classification, & Treatment

Diagnostic procedures

In order to determine what is causing your back pain, your doctor will most likely need the following information: 

  • Your medical history: This includes members of your immediate family who have back pain or other problems with their back. Some conditions, such as osteoporosis and scoliosis, have a genetic potential.
  • The history of your current condition: This includes details about when your back pain started, what first brought about your back pain, the severity of your pain at this time and what the pain feels like (burning, tingling, stabbing). Your doctor will also want to know if your back pain has changed since its onset, and he may ask other questions. His examination may cause some discomfort, so the doctor wants to know as much as possible about your pain prior to his exam.
  • Physical examination: The doctor will evaluate your heart rate and blood pressure, which may be elevated due to your back pain. He will also listen to your breath sounds and your heart. He will examine your spine, feeling for areas that are tender or painful and checking for abnormalities.  
  • Neurological examination: The doctor will assess for function and sensation. Sometimes physicians use the pin-prick test to determine if sensation is equal on both sides of the body. He may ask you to walk, bend and perform other movements to check your flexibility, function and range of motion, and the doctor will also test your reflexes to see if these have been affected by the cause of your back pain.  

Following a thorough physical examination and review of your symptoms, your physician may order special tests. The following diagnostic tests are used to help in the diagnosis of back pain:  

  • X-rays: X-rays are able to show how the bones are aligned and whether there are any broken bones that might be causing back pain. They can also detect the presence of arthritis. X-rays do not usually reveal problems with the spinal cord, discs or muscles.  
  • Magnetic resonance imaging (MRI): This test uses strong magnets and radio waves to provide detailed images of your body. It can show problems like herniated discs or problems with tendons, ligaments, nerves, muscles, tissues or bones that may be the reason for back pain.
  • Computerized tomography (CT scan):  This test uses special x-rays, taken at various angles, to show your doctor cross-section images of your spinal canal which are very detailed.
  • Bone scan:  This test can detect compression fractures that are caused by osteoporosis (brittle bones). These fractures can cause back pain without a fall or other traumatic injury. A bone scan can also detect bone tumors. A radioactive dye is injected into a vein. The dye collects in the bones, and a special camera is used to take detailed images that are then used for diagnosing back pain.
  • Electromyography or EMG: During this test, a needle is inserted through the skin into different muscles to check for electrical impulses. This test can help to confirm nerve compression that occurs when a spinal disc herniates or when the spinal canal is narrowed (spinal stenosis) and causes back pain. 
  • Blood Tests: If the doctor suspects an infection is causing your back pain, he or she may also order blood tests.