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Diagnostic Procedures for Low Back Pain and Its Treatments



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By : Patricia Strasser   

Low back pain can be detected through the following diagnostic approaches: obtain a medical history, conduct a physical examination, perform neurologic test, require blood test, and recommend imaging test. Such condition responds well to the following treatments: medication, rest, exercise, and surgery.

Low back pain or more commonly known as lumbago is a disorder affecting the muscle and bone. It can be due to muscle strain, ligamentous sprain or in rare cases nerve impingement. This can be classified according to the duration at which pain persists such as acute, sub-acute, and chronic. Since the degree of severity is dependent on the kind of internal structure involved, it is imperative to rule out other possibilities by conducting differential diagnosis through the following approaches:

Obtain a medical history

An initial evaluation of patient forms a vital part in determining a thorough medical history. The purpose of which is to arrive at the most accurate diagnosis possible. It is important to know how and when pain started as this will somehow form the basis in identifying the type of pain. Pain can be graded using 1 - 10 point of scale to determine its severity. Exacerbations as well as alleviation of signs and symptoms are closely observed. This will help pinpoint which movements are allowed and which are contraindicated. It must be established whether or not the pain is acute or chronic since treatment varies depending on the duration of pain. Patient must also be able to relay to the attending physician any pre-existing conditions to rule out health issues that may exhibit more or less the same signs and symptoms as low back pain.

Conduct a physical examination

Since patients' responses may be subjective, which means based on feelings not on facts, physical examination must be performed to strengthen the results. Tenderness, swelling, inflammation, and the likes should be noted to be able to tell the probable cause and nature of pain a patient is experiencing.

Perform neurologic test

A physician may conduct a series of neurologic tests to assess the presence of nerve impingement. Nerves are bundles of enclosed-fibers that are continuous with the spinal cord. Regardless of the origin, it functions either as sensory, motor or both. Once a nerve is impinged, this may result to pain or in worst cases, inability to move due to paralysis.

Require blood test

For some reasons, blood tests may be required to clear suspicions such as cancers, infections, and systemic conditions like rheumatoid arthritis. Although these are non-confirmatory, it gives the doctor a sort of hint on what to look for.

Recommend imaging test

This is a more reliable method of diagnosing low back pain and other health-related conditions because it produces images of internal organs and body parts. Some of the most common tests that can detect internal problems are the following:

* X-ray
* Computerized Tomography (CT) Scan
* Magnetic Resonance Imaging (MRI)
* Ultrasound Imaging
* Discography
* Bone scan
* Electromyography
* Thermography

With the aid of evaluation and testing, a medical practitioner will most likely be able to give the best and appropriate treatment available. Depending on the severity of the case, the condition can be effectively managed through the following:

Medication

In most cases, back pains are highly responsive to medications particularly NSAIDS or the Non-Steroidal Anti-inflammatory Drugs in reducing pain and inflammation. A simple alternate application of hot and cold compress may also contribute to the alleviation of suffering.

Rest

Apart from medication, the affected part must be totally rested and relaxed to give time for muscle repair. Cessation from activities particularly strenuous and repetitive is highly advisable.

Exercise

Once pain and inflammation have subsided, the treatment is now focused on restoring lost function and mobility. Since bed rest may cause weakness and reduction of muscle size, exercise accelerates its recovery. This is where the function of a Physical Therapist comes in to hasten recuperation as well as prevent progression of condition. Stretching and swimming are some of the safest and recommended work out activities for a previously injured back. However, if you feel aggravation of pain or even a slight discomfort; immediate termination of movement must follow.

Surgery

Although this is a rare option and the last resort performed, it is recommended to improve function of severely impaired patients. The main indication for surgery is nerve affectation, which requires release of pressure.

Regardless of the nature of pain, it is important to commence treatment the soonest and more importantly prevent progression that may cause limitation of motion.

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