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Initial exam for low back pain
Your doctor will begin by
asking questions about your medical history, your symptoms, and your work and
physical activities. He or she will also do a physical exam. The questions and
exam can help him or her rule out a serious cause for your pain. Your doctor may
also ask questions about stress at home and at work that may make you more
susceptible to chronic pain.
For most people with low
back pain, the doctor will be able to recommend treatment after the initial
exam. Your doctor will probably recommend that you begin home treatment and
possibly physical therapy.
If you are older than 50 or
you have symptoms of a specific illness, your doctor may recommend more tests.
Tests for low back pain
If your initial exam shows
no signs of a serious condition, you will probably not need to have an imaging
test. Imaging tests are typically done if:
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You are over 50 years of age.
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You have had spine problems since birth
(congenital spine problems).
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The history and physical exam reveal signs of
a serious problem, such as a fracture, tumor, infection, or severe nerve
damage.
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You have a history of any type of arthritis in
your spine.
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You have a history of a previous spine injury
or back surgery.
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You have a history of long-term steroid use or
a history of drug abuse.
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Back pain has not improved after at least 4
weeks of home treatment that may include pain relievers, heat or ice, and
exercises.
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Your symptoms are worse.
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You have had several episodes of severe pain.
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You and your doctor are considering surgery.
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Workers' compensation is involved because you
had an injury on the job.
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You are involved in a lawsuit concerning your
injury.
The type of imaging test
will depend on what kind of problem your doctor suspects. You may have one or
more tests, such as:
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Spinal X-ray.
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MRI.
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CT scan.
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Bone scan.
For more information about
MRI for low back pain, see: Should
I have an MRI for low back pain?
Imaging tests such as the
myelogram and discography have been largely replaced by simpler and more
effective methods for basic testing. They are sometimes still used in
hard-to-diagnose cases or before surgery. If your doctor recommends discography,
experts recommend getting a second opinion before having the test.
If you have leg pain or
numbness, you may have an electromyogram and nerve conduction studies to find
out how severely your nerve function is being affected. Electromyogram and nerve
conduction studies check the function of the spinal cord, nerve roots, and
nerves and muscles that control your arms and legs.
Blood tests are sometimes
used to look for a metabolic disorder, arthritis, cancer, or an infection. Bone
scans may also be used to look for cancer or infection.
Reference from Healthwise
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