When It Hurts to Sit, Stand or Sleep: Tests to Diagnose Back Pain Dr. Kaixuan Liu shares some of the top ways doctors figure out the cause of an aching back.
Low back pain is a common condition that affects people of all ages and backgrounds. The pain can range from mild to severe lower back pain and can be caused by a variety of factors, including poor posture, injury, or underlying medical conditions. To diagnose the cause of low back pain, healthcare providers use a combination of physical examinations, imaging tests, and laboratory tests.
Back pain is usually fleeting, with most cases lingering for less than 4 to 6 weeks. But when back pain becomes chronic, tests to diagnose back pain and lower back pain causes may be your best path to relief, according to Kaixuan Liu, MD, Ph.D., founder and Medical Director of Atlantic Spine Center.
About 80 percent of American adults experience back pain at some point in time, according to the National Institutes of Health. In some cases back pain lingers or just never gets better with the passage of time or the use of non-invasive measures such as pain medications, ice or heat application, or physical therapy. For these patients, Dr. Liu recommends tests to figure out the cause of their aching back.
"It often takes one or more types of diagnostic procedures to confirm a diagnosis," explains Dr. Liu, who is fellowship-trained in minimally invasive spine surgery. "But learning a precise cause for chronic back pain is the best way to target it with effective treatment interventions."
Diagnostic methods: What do these tests include?
- X-Rays: X-rays show how bones are aligned and if a patient has arthritis or bone breaks. X-rays alone won’t be able to show problems with the spinal cord, muscles, discs or nerves, however.
- Blood tests: Lab tests can show whether you have an infection or other condition causing your pain.
- Bone scans: In rare cases, these scans may indicate a bone tumor or compression fracture prompted by the bone-thinning disease osteoporosis.
- MRI scans: An MRI generates images that can show herniated spinal discs or abnormalities with bones, muscles, tissues, tendons, nerves, ligaments, and blood vessels.
- Electromyograms (EMG): An EMG monitors electrical activity in the muscles to distinguish between muscle disease and nerve root disease.
Before any tests are run, your doctor will take a thorough medical history, which can help determine the source of your back pain. You’ll be asked about the onset of pain, what makes it feel better or worse, and if you’ve had the pain previously.
"A thorough physical exam is also key," Dr. Liu says. "I’d be watching the patient for signs of nerve damage while they walk on heels, toes and the soles of their feet. I also test patients’ reflexes and test nerves and muscle strength. Other types of physical examinations may be needed based on what is learned."
The healthcare provider will perform a physical examination to assess the patient's range of motion, strength, and flexibility. The examination may include tests such as the straight leg raise test, which involves raising one leg while keeping the other leg straight to check for sciatica. The provider may also check for signs of inflammation or nerve damage.
Advantages of spinal diagnostic procedures
Tests to diagnose back pain offer many advantages to patients, Dr. Liu says. They include:
- More precise diagnosis
- High success rates
- Minimally invasive methods
- Quick recovery
- Same-day procedures
To prepare for your appointment with a spine specialist before getting diagnosed, Dr. Liu suggests you write a list of your symptoms and when they began, a list of all your medications, vitamins and other supplements you take and questions you want to ask your doctor.
"This bit of extra effort on the part of the patient will certainly pay off when we combine that information with specialized tests to diagnose their back pain," Dr. Liu says. "We all want to see our patients go back to living without back pain in the picture."
Diagnosing back pain causes can be challenging as there are many potential causes. It is important to have a thorough evaluation by a healthcare provider to determine the underlying cause and develop an appropriate treatment plan. The tests used to diagnose low back pain may include physical examinations, imaging tests, and laboratory tests. The appropriate combination of tests will depend on the patient's symptoms and medical history.
Learn about others who have experienced lingering back pain and their experience finding relief.