If you’ve been coping with back or neck pain for weeks or longer, it’s natural to want to know exactly what’s causing it. Fortunately, a growing variety of leading-edge diagnostic tests are available to pinpoint exactly what may be wrong with your spine, according to Kaixuan Liu, MD, PhD, founder and medical director of Atlantic Spine Center.
Some newer diagnostic tests even do double duty, Dr. Liu says: They offer pain relief while simultaneously empowering doctors to determine whether surgery, nerve blocks or other advanced treatments would benefit patients struggling with chronic pain.
“The past decade has expanded our ability to make a precise lower back pain diagnosis and determine back pain causes that can limit patients’ capacity to live life to the max,” Dr. Liu explains. “From imaging tests to injections to nerve conduction assessments, spine doctors have more options than ever to help patients learn what’s causing their situation, which in turn can ensure accurate, personalized treatment to hopefully rid them of the condition.”
When a person experiences pain in the spine, it is essential to determine the underlying cause to develop an appropriate treatment plan. To diagnose the source of spinal pain, various diagnostic tests are available that provide valuable information about the condition. Here are some commonly used tests for identifying the causes of spine pain:
Diagnosing a spine condition technically starts before any tests have been performed. The first thing your doctor will do is thoroughly review your health history and give you a physical exam, Dr. Liu says.
“You’ll be asked what your symptoms have been and when they started,” he adds, “and your doctor will also assess factors such as pain level, reflexes, muscle strength and range of motion.”
Next, your doctor may choose to perform one or more diagnostic tests. These can include:
- Blood tests. Blood tests may be ordered to identify underlying infections, autoimmune conditions, or inflammatory markers that could be contributing to spine pain.
- X-rays. X-rays are often the first imaging test performed for spine pain. They provide a detailed view of the bones in the spine, which can help identify fractures, degenerative changes, or abnormalities in the alignment of the vertebrae.
- MRI or CT scans. These are images that can reveal herniated spinal discs or problems with bones, muscles, tendons, ligaments or blood vessels.
- Myelography. This combines an injected contrast mixture with X-rays or CT scans to view abnormalities of the spine.
- Electromyelography (EMG). Measures electrical impulses of nerves and responses of muscles, and can show nerve compression from herniated spinal discs or a narrowing of your spinal canal.
- Nerve conduction velocity (NCV) studies. Which may be combined with an EMG to tell the difference between nerve and muscle problems.
- Bone scan. A bone scan is a nuclear imaging test that can detect abnormalities in bone metabolism. It is useful for identifying infections, fractures, tumors, or areas of abnormal bone growth in the spine.
- Spinal probing. Helps pinpoint pain areas through gentle probing, which enables the patient to report their pain response.
- Nerve root blocks. This type of block injects a steroid and anesthetic into the area where a nerve exits the spinal column to determine if surgery would be helpful.
- Medial branch nerve block injections. Injections of anesthetic to block pain from facet joints in the spine, help determine if long-term pain relief can be achieved with procedures such as nerve ablation.
It’s true that all diagnostic tests for the spine take time to perform, and some, while minimally invasive, may require a short recovery period. But these minor drawbacks are dwarfed by the many benefits of undergoing such a thorough evaluation, Dr. Liu points out.
These advantages include:
- More precise diagnosis
- High success rates
- Same-day procedures
- Non-surgical approaches
- Quicker recovery
Once the testing process is complete, patients ultimately benefit from receiving a well-considered, highly accurate diagnosis of the spinal issue that’s been triggering their chronic pain.
“There’s great satisfaction in being able to tell a patient, ‘We know exactly what your spine problem is, and exactly how to fix it,’” Dr. Liu explains. “And they couldn’t be happier when we do.”
It's important to note that diagnostic tests should be interpreted in conjunction with a thorough clinical evaluation by a healthcare professional. The specific tests recommended will depend on the individual's symptoms, medical history, and physical examination findings.
In conclusion, a range of diagnostic tests is available to identify the causes of spine pain. X-rays, MRI scans, CT scans, EMG, discography, bone scans, facet joint injections, and blood tests all play a role in evaluating spinal conditions. These tests provide valuable information that aids in accurate diagnosis and helps guide appropriate treatment plans for individuals experiencing spine pain.