Diagnostic Tests for Identifying the Causes of Pain in the Spine

DiagnosticBack Pain Causes

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 precisely diagnose what’s triggering back and neck pain 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.”

Test Options

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. Which can indicate infection that’s causing your pain.
  • X-rays. A radiographic picture of your bones and their alignment.
  • 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. These scans can look for rare bone tumors or compression fractures from the bone-thinning disease osteoporosis.
  • Spinal probing. Helps pinpoint pain areas through gentle probing which enables the patient to report their pain response.
  • Nerve root blocks. This type 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, helping determine if long-term pain relief can be achieved with procedures such as nerve ablation.

Many advantages

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.”