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Back problems diagnosis

Most people will experience some kind of back pain during their life, whether from poor posture, lifting something heavy, an accident or other causes.

In many cases back pain will clear up within 12 weeks and may be relieved with over the counter pain relievers.

Seek medical advice if the pain is severe, is associated with symptoms such as loss of feeling or weakness in legs, is affecting your daily life or if you have concerns.

How do I know what kind of back problem I have?

Unless you are totally immobilised from a back injury, your doctor will probably test your range of movement and nerve function and examine your body to locate the area of discomfort.

Blood and urine tests will make sure the pain is not due to an infection or other systemic problems.

X-rays are useful in pinpointing broken bones or other skeletal defects. They can sometimes help locate problems in connective tissue. To analyse soft-tissue damage CT scans or MRI scans may be needed. X-rays and imaging studies are generally used only for examining direct trauma to the back, back pain with fever, or nerve problems such as weakness, or numbness, of the extremities. To determine possible nerve or muscle damage an electromyogram (EMG) can be useful.

How do I know what kind of back problem I have?

Medical history

  • Because many different conditions may cause back pain, a thorough medical history will be recorded as part of the examination. Some of the questions you are asked may not seem pertinent to you but are very important to your doctor in determining the source of your pain.
  • Your doctor will first ask you many questions regarding the onset of the pain. For example, were you lifting a heavy object and felt an immediate pain? Did the pain come on gradually? He or she will want to know what makes the pain better or worse. The doctor will ask you many questions referring to the ‘red flag’ symptoms. He or she will ask if you have had the pain before. Your doctor will ask about recent illnesses and associated symptoms such as coughs, fevers, urinary difficulties, and stomach illnesses. With females, the doctor will want to know about vaginal bleeding, cramping, or discharge. Pain from the pelvis, in these cases, is frequently felt in the back.

Physical examination

  • The doctor will look for signs of nerve damage while you walk on your heels, toes and soles of the feet. Reflexes are usually tested using a reflex hammer. This is usually done at the knee, behind the ankle, and on the soles of the feet. As you lie flat on your back, one leg at a time is elevated, both with and without the assistance of the doctor. This is done to test the nerves, muscle strength and assess the presence of pressure on the sciatic nerve. Sensation is usually tested using a pin, paperclip, broken tongue depressor or other sharp object to assess any loss of sensation in your legs.
    • Depending on what the doctor suspects is wrong with you, he or she may perform an abdominal examination, a pelvic examination or a rectal examination. These examinations look for diseases that can cause pain referred to your back. The lowest nerves in your spinal cord serve the sensory area and muscles of the rectum, and damage to these nerves can result in inability to control urination and bowel movements.
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