When you have back pain that doesn’t go away within a few weeks, your doctor will likely want you to have back pain tests to determine the cause of the pain and suggest treatment that will effectively deal with it.
What types of tests will a back specialist suggest?
Two common tests to determine the cause of your back pain involve physical and neurological tests. Physical tests, such as moving your arms, will identify what movements cause pain. Neurological tests will test muscle strength, reflexes, and nerves.
However, those aren’t the only tests that you’ll likely have to undergo.
Depending on what your doctor thinks is the problem at play, you might have to undergo different types of tests.
Here’s a rundown of common back pain tests.
If you’d like to see a graphical breakdown of the back pain tests, we got you covered:
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- 1 Types of Physical Tests
- 2 Blood Tests
- 3 X-Ray
- 4 CT or CAT (Computerized Axial Tomography) Scan
- 5 MRI (Magnetic Resonance Imaging)
- 6 Bone Scan
- 7 Discogram
- 8 Electromyogram (EMG) and Nerve Conduction Studies (NCS)
- 9 Diagnostic Injections
- 10 Spinal Tap
- 11 Are Imaging Tests Really Necessary?
- 12 Related Questions
- 13 Conclusion
Types of Physical Tests
To start off with, your GP doctor might want to ask you questions and test your body in various ways to see what might be causing your back pain.
- Testing for weakness. Your muscles will be monitored during various tasks and movements. Your doctor might ask you to lift your arm or leg and see how they fare when light resistance is placed on them.
- Testing for spine and neck motion. Your doctor will ask you if you feel pain in your back or neck when you do certain movements, such as bending or twisting around.
- Testing for sensory changes. The doctor will touch your feet and hands and see if you feel certain sensations in different parts of them.
- Testing your reflexes, such as kneecaps and ankles.
- Testing for motor skills. You might be asked to walk on your heels or toes.
- Testing for other problems. Sometimes, the pain you feel in your back or neck is referred pain from elsewhere in the body. Your doctor might ask you questions to find out if you’re experiencing other symptoms, such as a fever or weight loss, that can point to other conditions.
While blood tests are by no means a comprehensive way to determine the cause of your back pain, they can be useful if your doctor suspects that you could have an infection, such as a kidney infection.
A blood test can also offer valuable information if you have inflammatory arthritis, which is when your immune system is overactive or doesn’t work in the way it should.
This is one of the first imaging tests your doctor will want you to do.
An X-Ray is important because it basically shows your doctor what the bones in your spine look like, and it can help him or she see immediately if there are problems with them.
For example, are there narrowed channels in the spine that can point to spinal stenosis? Or, is there evidence of osteoarthritis?
There are different types of X-Rays. One type that can be beneficial for viewing the spinal cord is a myelogram.
A myelogram is a spinal canal X-Ray.
How it works is that contrast material is injected into the cerebrospinal fluid spaces and then an X-Ray displays any problems there, such as pressure that’s being placed on the spinal cord or nerves as a result of conditions such as tumors, bone spurs, or herniated discs.
What’s so interesting about this type of X-Ray is that the radiologist will be able to see how the contrast material travels in real-time thanks to the use of fluoroscopy.
However, this type of X-Ray also takes images. It’s beneficial after surgery to see if there is an improvement, but can also be useful for checking for disc problems in people who cannot have an MRI scan.
CT or CAT (Computerized Axial Tomography) Scan
If your doctor suspects a spinal problem, he or she will recommend a lumbar spine CT scan.
Conditions such as a pinched nerve, weakness in the arms or legs, and a herniated disc, to mention just a few, can be picked up during a lumbar spine CT scan, as Healthline reports.
A CT scan is a combination of X-Ray equipment with computers to create two-dimensional slice images of your body.
Sometimes these images can be turned into 3D views of your back.
Since CT scans reveal soft tissues and muscle much clearer than regular X-Rays, they’re a valuable test for diagnosing conditions that cause back pain.
MRI (Magnetic Resonance Imaging)
An MRI goes one step further than a CT scan.
This type of imaging test provides much clearer and detailed views of the muscles, cartilage, discs, blood vessels, and tendons in the back.
There are two types of MRI scans that you could have for back pain. They are the lumbar MRI and cervical MRI.
A lumbar MRI scan will study the spine’s lumbar section, which is the lower back. This is where many back problems tend to originate.
The lumbosacral spine will also be looked at. This consists of five lumbar vertebral bones, the sacrum (located at the bottom of the spine), and the coccyx.
There are also nerves, ligaments, cartilage, and blood vessels in this area of the body, as Healthline reports.
If you have the following symptoms, your doctor might order a lumbar MRI scan to see what the problem could be.
In addition, this scan might be performed before back surgery to help the surgeon plan for it.
- Back pain with fever
- Birth defects that affect your spine
- Back pain as a result of injury
- Back pain that won’t go away
- Back pain that’s severe
- Back pain that’s accompanied by bladder problems
- Leg weakness or numbness
A cervical MRI is another type of MRI scan that can help to diagnose problems with the spine, however, it focuses on the cervical spine.
That’s the part of the spine that’s found in the neck.
Basically, the neck is part of the spinal column that moves through the body and the cervical spine is made up of seven bones that are separated by intervertebral discs, as explained by the American Association of Neurological Surgeons.
Your doctor will order a cervical spine MRI if he or she wants to check for the following problems in the area:
- Herniated discs
- Soft tissue disorders
- Joint disorders
- Vascular disorders, such as aneurysms
- Bone abnormalities
- Injuries or trauma
If your doctor suspects that you could have a problem with your bones, such as a fracture, he or she will suggest a bone scan to see the bones in a clearer way.
During a bone scan procedure, radioactive dye is injected into a vein in the arm and circulates through the body and spinal bones.
Then, a camera scans the area to display places where there’s more blood flow. This can indicate conditions such as tumor, infection, or fracture.
There are some back pain tests that are used for specific conditions that your doctor suspects.
A discogram is an example. Your doctor might want to do a discogram if he or she suspects that you have a condition that’s affecting the discs in your back, such as a disc tear.
To conduct a discogram, you’ll be injected with a radiopaque dye that goes into the disc, and this is followed by a CT scan to show any disc problems.
If the dye remains inside the disc’s center, then the disc is working normally.
However, if the dye moves out of the center, then the disc has been damaged, such as by wear and tear, as explained by Mayo Clinic.
A discogram isn’t usually the first test a doctor will order to gain more information about your back pain.
If the pain has persisted or has become worse despite other treatments, then it could be considered.
However, it will usually be done along with other tests, such as a CT or MRI scan, so that your treatment can be better determined.
Electromyogram (EMG) and Nerve Conduction Studies (NCS)
These are tests that measure the electrical impulse along with the nerve roots and muscle tissue.
They are useful because they can show if there is nerve damage or compression in the back.
If you’ve been experiencing sore or weak muscles, then these tests can help doctors to find out why.
- An electromyogram measures how your muscles respond to nerve signals from the brain. If your muscles are shown not to respond as they should, you might have a neuromuscular disorder.
- A nerve conduction study will measure how quickly and strongly the nerve’s electrical activity is. If they have a problem you might experience symptoms such as weakness in your muscles, tingling, or even pain. The NCS test will reveal if your nerves have been damaged.
How an EMG works is that you’ll have a few electrodes or small needles inserted into your skin and muscle.
They will pick up the electrical activity and this activity will be displayed on a monitor (oscilloscope) in the form of waves.
Activity will be measured when the muscle is resting and when it contracts, so during the test, you’ll likely be asked to contract your muscles.
An NCS test is performed in a similar way, with the use of electrodes.
However, it makes use of a recording electrode that’s attached to the skin over a nerve that should be monitored.
A stimulating electrode is placed a bit further away and its purpose is to stimulate the nerve with a mild and quick shock.
This nerve stimulation will be displayed on an oscilloscope, as John Hopkins Medicine explains.
Both of these tests will help doctors to diagnose the following problems:
- Nerve problems in the spine, such as herniated discs
- Compressed nerves
- Neuromuscular diseases such as muscular dystrophy
- Guillain-Barré syndrome, which is when the immune system attacks nerves in the limbs
While you might get a back injection to relieve your pain, some of these injections can also help your doctor to diagnose what’s wrong with your back.
These types of injections include selective nerve root blocks, facet joint injections, and more.
These injections have the benefit of giving you a bit of pain relief – usually up to 12 hours – and by doing so, they can show your doctor what’s wrong.
If you get pain relief after one type of back injection, that tells your doctor where the problem is. If you don’t, then the doctor will be able to assume that the pain has a different origin.
These types of back injections usually make use of medication to treat the pain in the area, such as in a joint, as well as a local anesthetic which also has pain-relieving properties.
Sometimes, your doctor might want to get a sample of the spinal cord’s cerebrospinal fluid – this is fluid that surrounds the spine and brain.
By doing a spinal tap, the doctor will be able to check the content and pressure of that fluid. If there are problems with it, then you might have an infection, bleeding, or inflammation.
During a spinal tap, a needle is inserted into the spinal canal in the lumbar region, as The University of Maryland Medical Center reports.
A sample will be retrieved from between two vertebrae.
A spinal tap can help diagnose conditions such as multiple sclerosis, cancer, meningitis, and central nervous system disorders.
If your spinal fluid is cloudy or pink in color, this could point to abnormal bleeding.
Infections can also be noted if there is too little glucose in the spinal fluid or too much protein. If there are bacteria found in the spinal fluid, this also indicates an infection.
Are Imaging Tests Really Necessary?
Sometimes it might feel like rushing to your doctor for imaging tests to diagnose what’s causing your back pain is unnecessary.
Indeed, this can be the case if you haven’t had your back pain for a long time.
Most people who experience back pain will feel better in about a month, as Choosing Wisely reports, and that’s the case whether or not they get imaging tests.
So, the important thing to remember is that if your pain is not severe and you haven’t had it for longer than a few weeks, and it doesn’t have any other symptoms, then you should go ahead and try to treat it at home before contacting your doctor.
Following this guideline can also save you unnecessary spending.
According to a report that was published in The National Institute for Health Care Management (NIHCM) Foundation, people in America spend over $100 billion on diagnostic imaging every single year, and a large amount of it is unnecessary.
That said, if you’re suffering from a lot of pain, or you’re experiencing other troubling symptoms, such as numbness, weakness, lack of bladder control, and fevers, then it’s time to see the doctor who might want to send you for imaging and other tests.
In fact, in those cases, your back pain should be treated as an emergency for which you shouldn’t delay getting medical help.
The bottom line is that when they’re really necessary, back pain tests can be highly beneficial to help you understand what’s causing your pain and get you onto the right treatment to eliminate or better manage it.
What can I do to heal my back pain?
There are many things you can try, bearing in mind that most cases of back pain will go away on their own.
How can you prevent back pain?
It’s not always easy to prevent back pain, but you can prevent some conditions and injuries by maintaining good posture, doing regular exercise (at least 150 minutes a week), maintaining a healthy weight, and engaging in stress-relieving activities.
If you’re suffering from back or neck pain, your doctor might want to conduct some tests.
As outlined in this article, the various tests all have the purpose of determining what’s causing your pain and how to best treat it.
Some of these back pain tests won’t be ordered quickly.
Instead, your doctor will suggest one or multiple tests if you haven’t been getting relief from your pain with other treatments and home remedies.Last updated on: