Diagnosing Lower Back Pain


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When it comes to diagnosing lower back pain, the doctor relies on the case history, the physical examination and the tests. The majority, say about 85% of diagnosis depends on the case history of the patient. There are a set of questions that the sufferer is suppose to answer like the beginning of the pain, frequency, the areas of pain (legs, back or elsewhere), what triggers the pain? Is the pain associated with some other physical change? There could also be questions about the bowel functioning. After the history has been noted down, the doctor moves on to do physical examination of the case.

The physical check-up contributes 10% to the diagnosis. The doctor would look for particular signs or symptoms that would match the case history. But, the doctor has to be very careful whether the history and the present symptoms match or not. The symptoms could be as follows:

* Tenderness in the lumbar spinal area.
* The signs patients show after 'crossed leg and straight leg raising'. If the patient feels pain on raising the leg, it could be a problem in the nerve root. A 'crossed leg raising method' of physical examination indicates herniated disc and this test has 96% success rate in doing so.
* Feeling of weakness in the lower limbs is also an indicator of lower back problems.
* Experience of sensory changes in the lower area of the body, it could be numbness in the foot or the little toe.
* If there is pressure on the nerve, it can result in some reflex changes as a result.

After various physical tests, the patients may have to undergo other medical tests for confirmation like the following:

* Lumbar spine films: These X-ray films give a clear picture of the alignment of the spine. They also detect fractures and tumors in and around the spinal area.
* CT scans: These are best for the cross-sectional view of the spine. CT scans give a clearer picture of the ailing area.
* MRI scans: These are not very different from the CT scans but they use magnetism and not X-rays to get images of the ailing area and other regions of interest. These provide images in the form of slices and bones are better viewed on the CT scans.
* Myelograms: In this test, the radiologist inserts the radio-opaque dye into the spinal fluid to detect abnormality. This test is only used when the MRI fails or if the patient has a pacemaker.
* EMG/NCV studies: Detects the electrical functioning of the nerves and the muscles.
* Bone density tests: Measures the strength of the bones and their density.