Diagnosis of Back Pain

Diagnosing the underlying cause of neck and back pain can be difficult. A medical history is taken and a complete physical examination, which may include a neurological examination, is performed.

Laboratory Tests to Diagnose Back Pain

X-rays can show the alignment of the cervical, thoracic, and lumbar spine and may reveal degenerative joint disease, fracture, or tumor.

Magnetic resonance imaging (MRI scan) provides clear images of disc deterioration, pathologies of the spinal cord, spinal stenosis, herniated discs, spinal tumors, and abnormalities in nerves and ligaments. Contrast dye may be injected to highlight problematic areas.

Computerized tomography (CT scan) is an x-ray that utilizes computer technology and can be enhanced with contrast dye. It is used to show abnormalities in bones and soft tissue. CT scan can be used for patients who are unable to tolerate MRI.

Myelography is used to examine the spinal canal and cord. Contrast dye is injected into the cerebrospinal fluid to outline the spinal cord and nerve roots, thus allowing abnormal disc conditions or bone spurs to be visualized with x-ray or CT scan.

Electromyogram (EMG) uses tiny electrodes inserted into muscle tissue to test for abnormal electrical signals, which may indicate that a nerve root is pinched or irritated at the spine.

Spinal tap involves drawing a sample of cerebrospinal fluid and analyzing it for elevated pressure, infection, bleeding, or tumor.

Bone scan locates problems (e.g., fracture, osteoporosis) in the vertebrae. A radioactive tracer is injected into the patient and after several hours, x-ray will reveal bone undergoing rapid changes where large amounts of tracer accumulate.

Publication Review By: Eric M. Schreier, D.O., F.A.A.P.M.R.

Published: 31 Dec 1999

Last Modified: 01 Sep 2015