Your care team will ask you about the following:
- Pain and other symptoms. Where is it? How bad is it? How long have you had it? When did you first notice it? What makes it better or worse? How is your life affected by your symptoms - have they changed your sleep habits, your work life, your recreation? They may ask you to rate your pain on each visit to assess improvement.
- Previous medical care. What tests or treatments have you already had? What were the results? What medications do you take?
- Lifestyle and daily habits. Do you smoke? Exercise? What kind of work do you do? How do you usually sleep, sit, stand?
- Family history. Does anyone else in your family have back trouble or chronic pain?
- Overall physical and emotional health. Do you have any chronic conditions such as arthritis or osteoporosis? Have you had cancer, depression, or an infection? How would you rate your recent and current stress level? What do you do for fun and relaxation?
- Other. Pain is not the only symptom we care about. Your medical assessment should cover a range of symptoms such as the following:
- Numbness, tingling, “pins and needles”
- Bowel or bladder problems
- Stress or emotional issues
- Fever, chills, sweating
- Weakness, slow reflexes
- Dizziness, headaches
- Sexual dysfunction
- Unusual weight gain or loss
Mention these or any other unusual change or symptom to your care team. Even if it seems unrelated to your spine or doesn’t bother you, it will help your providers get a more complete picture.
In a physical exam, your doctor will check your body and its movement. Your doctor may note:
- Weakness: Simple exercises can help test your strength.
- Range of motion: Your doctor may check your flexibility or watch you bend and twist.
- Tenderness: Your doctor may assess areas of soreness by touching parts of your body.
- Sensation and sensitivity: Your doctor may check to see that you can feel heat, cold, or a pin prick on a part of your body.
- Reflexes and motor skills: Your doctor may ask you to walk on your heels or toes, or do tests to check your body’s reactions.
- Shape, tone, and position of the spinal bones, muscles, and so on.
Sometimes back and neck symptoms can be caused by, or made worse by a systemic illness (an illness throughout your body, not just in your spine). To check for illness, your doctor may request a test of a sample of your blood or urine.
There are several technologies that allow your spine team to take pictures of the inside your body. In some instances, you may have already done these studies. Depending on how long ago that was, or the quality of the images, you may be asked to have repeat studies. They may suggest one of the following imaging studies:
- X-ray: Beams of low-dose radiation create pictures of tissues, bones, and organs on film.
- MRI: Magnetic Resonance Imaging (MRI) uses a magnetic field and radio waves to create images. It’s useful for showing details of soft-tissue structures near and around bones and joints.
- CT scan: Computed tomography (CT) uses a computer and x-rays to create cross-section views (“slices”) of areas of the body. It’s especially useful for highlighting abnormal tissue and clearly showing very small bones.
- Bone density scan: This scan uses x-ray or ultrasound to measure the amount of bone in a particular area. It can detect and assess osteoporosis (thinning bones).
The term “electrodiagnostic testing” covers a range of tests that measure electrical activity in nerves and muscles. Two common electrodiagnostic tests are the electromyogram (EMG) and the nerve conduction study (NCS). Results from these tests help your doctor assess nerve and muscle function and locate any damage.
Other procedures, like spinal injections and discography, may also be useful in finding sources of back pain that may not show up in common imaging studies. Your care team will provide information on these procedures as needed.