How is it Diagnosed?
Back pain is diagnosed primarily through a detailed clinical evaluation, supported by
imaging and laboratory tests when necessary. The diagnostic process begins with a
thorough medical history, including the onset, duration, location, and intensity of pain.
Physicians also inquire about associated symptoms like numbness, weakness, or
bladder/bowel dysfunction, which may indicate nerve compression or spinal pathology.
A physical examination assesses posture, range of motion, reflexes, muscle strength,
and areas of tenderness. Red flags such as unexplained weight loss, fever, trauma, or
history of cancer prompt immediate investigation.
If the back pain persists beyond 4-6 weeks or is accompanied by neurological signs,
imaging studies are recommended. X-rays may reveal fractures or structural
abnormalities. MRI is the gold standard for evaluating disc herniation, spinal stenosis, or
infections. CT scans may be used when MRI is contraindicated.
Blood tests may be conducted to rule out infections or inflammatory conditions such as
ankylosing spondylitis. Electromyography (EMG) and nerve conduction studies may be
ordered if nerve involvement is suspected.
In rare cases, bone scans or dual-energy X-ray absorptiometry (DEXA) may be used to
assess bone disorders or osteoporosis. The diagnosis aims to classify back pain as
mechanical, neuropathic, or systemic in origin to guide effective treatment strategies.