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Evaluation
of back and neck pain requires a physician experienced in diagnosing spinal
conditions. The work-up begins with a detailed history and physical examination.
Your medical history helps your doctor understand your back and neck pain,
and the influence of your lifestyle in contributing to your pain.
During your physical exam, your physician examines you to pinpoint the source
of pain. Simple tests for flexibility and muscle strength may also be conducted.
Diagnostic tests may be ordered to confirm the location and source of your
pain.
Diagnostics may include
- X-rays
are usually the first step in diagnostic testing methods. X-rays show bones
and the spaces between the bones.
- MRI
(Magnetic Resonance Imaging)
uses a magnetic field and radio waves to generate highly-detailed pictures
of the inside of your body. Because X-rays only show bones, MRIs are needed
to see soft tissues like discs in the spine. These images help your doctor
provide a more accurate diagnosis. This type of imaging is very safe and
usually pain free.
- CT
scan/myelogram
- A CT scan is similar to an MRI in that it provides more diagnostic information
about the internal structures of the spine. A myelogram is used to diagnose
a bulging disk, tumor or changes in the bones surrounding the spinal cord
or nerves. A local anesthetic is injected into your lower back to numb the
area. A lumbar puncture (spinal tap) is then performed. A dye is injected
into the spinal canal to reveal where problems lie.
- Electrodiagnostics
- Electrical testing of the nerves and spinal cord may be performed as part
of our diagnostic workups. These tests, called Electromyography (EMG) or
Somato Sensory Evoked Potentials (SSEP), assist your neurosurgeon in understanding
how your nerves or spinal cord are affected by your condition.
- Bone
Scan
- Bone imaging is used to detect infection, malignancy, fractures and arthritis
in any part of the skeleton. Bone scans are also accurate for finding lesions
for biopsy or excision.
- Discography
- Discography is used to determine the internal structure of your disk.
It is performed by using a local anesthetic and injecting a dye into your
disk under X-ray guidance. An X-ray and CT scan are performed to view the
appearance of the disk composition to determine if its structure is normal
or abnormal. In addition to your disk appearance, your doctor will note
if you have pain with this injection. The benefit of a discrogram is that
it enables the spine surgeon to confirm which disc level is really causing
your pain. This ensures that surgery will be more successful and reduces
the risk of operating on the wrong disc.
- Injections - Pain relieving injections can relieve back pain and give the physician important information about the problem, as well as providing a bridge therapy.
Need
more information on back and neck pain?
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