Diagnosis



To enable the doctor to diagnose the problem correctly the complete history of the back pain should be provided. The doctor may ask a number of questions as listed below:

• What are the symptoms?
• What kinds of aches or pains?
• Where exactly is the pain?
• Where is the pain the most severe?
• When did the pain begin?
• How long it lasts?
• Did something specific cause the back pain, such as anaccident or injury?

• What home treatments is undertaken?
• Was there any additional stress when the pain began?
• Is there any other health problems?
• What kind of work does the patient do?
• Types of recreational activities in which the patientparticipates.


Next, the doctor will make a clinical/physical examination. During the exam, the doctor may perform any of the following:


• observe the muscles and joints

• ask to sit and lie down

• ask to move the back in different positions

• observe the most painful area

• check if other areas of the body are tender or painful (suchas the kidneys, intestines, or other organs).
If the doctor can identify the likely cause of the back pain, at this point, no further tests will be needed. If the doctor needs more specific information, the following tests may be advised:


X-ray


Studies show that in many cases of routine back pain, X-rays may not initially be necessary. However, the signs and symptoms will determine what type of study should be done. In certain cases, X-rays might indicate that the pain is due to:


• inj ury in one or more of the back bones
• a tumor in the spine
• a deformity in the spine
• ankylosingspondylitis


CAT Scan (Computerized Axial Tomography)
Only a few people with lower back pain need a CAT scan. If the doctor advises one, a special machine takes an x-ray scan of the area. A computer turns this scan into a three-dimensional view of the back. This helps the doctor see if there is a ruptured disc that can't be seen on regular x-rays; CAT scan also helps in detecting spinal stenosis, tumors and infections of the spinal cord.


MR1 (Magnetic Resonance Imaging)


MRI is another way to make very clear pictures of parts of the spine. The MRI does not use X-rays or radioactive dyes. It can provide clearer pictures of soft tissues such as muscles, cartilage

ligaments, tendons and blood vessels in addition to bone structure. To take a MRI picture, the body must be moved very slowly through a tube in the centre of the machine, which contains very powerful magnets. People, who are claustrophobic or whose bodies contain certain kinds of metal objects, may not be able to tolerate the procedure.


The MRI scanner shows the nerves and disc quite clearly. No special dyes or needles are necessary. The MRI scan is, perhaps, too good at showing the anatomic details of the spine. There is a growing body of evidence that suggests that not all abnormalities that show up on the MRI scan are really the cause of the individual patient's problem related to back pain. Abnormalities, such as bulging discs, show up frequently in normal persons who have never had any problem with their back. Hence, it should be kept in mind that a MRI scan is a great test to show the lumbar spine anatomy and it must be correlated carefully with the symptoms so that the findings
aren't blown out of proportion.

•
lypes of Back Pain
Back pain may be acute (generally severe, but short-lived), subacute or chronic (long-lasting or occurring often).
cute Back Pain

• Pain usually lasts from one to seven days.

• Pain may be mild or severe.
An accident or injury occasionally may cause pain.

• About 80 percent of all back pain are acute.