How Are Spine Disorders Diagnosed?

Given that back pain affects the vast majority of adults on a global level, diagnosing back conditions and diseases requires a complete and detailed history and physical examination and potentially diagnostic tests / images.

When a person goes to the doctor with back pain, whether neck, upper or lower back, the doctor will likely review the patient’s physical history and ask a series of diagnostic questions. These questions will be the start of determining the correct treatment that offers relief for the patient.

Questions Your Doctor May Ask About Your Back Pain

  • Have you had any injury/ies that could be contributing to the pain?
  • Do you have a family history with any bone conditions like osteoporosis?
  • When did the pain begin, where did it originate, and what is the intensity of the pain?
  • What types of remedies and body positions aggravate or lessen the pain?
  • Do you have any issues with bowels or bladder?

Your doctor may also ask you to describe your pain in a different way, describing the intensity of pain when doing certain daily activities.

Description of the activities when the back pain can occur

It is important to be as detailed as possible when describing your back pain. Try to explain where the pain occurs in your spine as well as if you have pain in your arms and legs and the type of pain, for example shooting pains, numbness or weakness. Many doctors may ask you to rate your pain from zero to 10 and also explain what time of day you feel the most pain and in what position you are at the time such as lying down in bed, walking, sitting, etc. Your doctor may also want to test your neurological function to properly diagnose your condition. You’ll want to share your family history, lifestyle, physical factors and any injuries you have sustained because they all help create a picture that helps your doctor.

Whether you are experiencing acute, sub-acute or chronic back pain, try to keep a journal of what is happening so you can help your doctor get to the root of your problem and prescribe the most effective treatment.

Ask yourself the following questions:

  • Where on your spine is the pain?
  • When did the pain start?
  • Was there an incident or injury that precipitated the pain?
  • Did the pain come on abruptly or gradually?
  • Rate the intensity of the pain at certain times of the day and in certain positions:
    • What time of day is the pain the worst? The least?
    • In what position is the pain the worst? The least?
  • Does the pain travel to your arms or legs, other parts of your spine or to your brain?
  • Do you have any family history of back problems, and if so, what conditions, e.g., osteoporosis, arthritis?
  • Do you or have you had problems with your bladder or bowels?

Your doctor will want to understand if you have any underlying conditions that may cause the pain including tumor, epidural hematoma, abscess, or disc herniation.

There are several conditions that may require additional testing. If you have any fractures or spinal cord compression, or you have tried and exhausted all non-surgical pain management techniques and your back pain does not feel better, your doctor may prescribe one or more types of tests to further diagnosis your back disorder.

  • Bone scan
  • Computed tomography (CT scans)
  • Discogram
  • Electromyelogram
  • Laboratory tests
  • Magnetic resonance imaging (MRI
  • Myelogram
  • Spinal tap
  • X-rays