Diagnosing neck and back pain: testing reflexes, nerves and muscular strength

Neck or back pain can be caused by a number of different injuries and conditions, with different causes of back pain affecting different systems of the body, including the muscular, skeletal and nervous systems. That’s why physicians will often perform a variety of tests aimed at finding issues in one or all of these systems in order to find and confirm a diagnosis.

Reviewing medical history and performing a physical exam are often the first steps toward coming to an accurate diagnosis of neck or back pain. The history and physical examination provide much of the necessary information to determine the cause of the pain. Tests that target the patient’s reflexes, nerves and muscular strength are almost always a component of the physical exam. These tests are very helpful in indicating problems like herniated discs, sciatica, pinched nerves and other spinal conditions.

How does the doctor test reflexes and muscle strength?

During a physical exam, the physician may ask you to:

  • Walk on your toes
  • Walk on your heels
  • Walk on the soles of your feet

These tests help gauge the strength in your leg muscles. They can also help a doctor tell if there is nerve damage as the result of a degenerative spinal condition.

For the reflex test, the physician will gently strike the knee and the back of the heel with a small rubber hammer. If your reflexes are normal, the hammer strike should cause a twitch in the leg being tested.

When do reflex and muscle tests indicate nerve damage?

Reflexes may be depressed or exaggerated if there is some form of nerve dysfunction. In this case, the size of the reflex response helps to identify where the problem originates. For example, exaggerated response may indicate spasticity caused by a disorder of the central nervous system, while patients who have trouble walking on their heels or rising to their toes may be dealing with nerve root compression caused by a spine condition.

Each nerve root in our spine contains two fibers: a sensory fiber and a motor fiber. The sensory fiber supplies sensation to a certain zone of skin on your body, called a dermatome. Similarly, the motor fiber is responsible for allowing certain muscle groups to move. The specific group of muscles supplied by the same nerve root is called a myotome. If the physician detects weakness in a certain myotome, it may indicate that the corresponding nerve is impaired in some way, usually due to a disc injury that is causing the nerve root to be compressed.

Treatment for neck or back pain

Upon diagnosis of a degenerative spine condition causing neck pain, back pain or symptoms in the extremities, most doctors will recommend a course of conservative treatments such as medication or physical therapy. Surgery may become an option if you and your doctor believe nonsurgical options have been exhausted without bringing the relief necessary for a good quality of life.

For patients in this situation, Laser Spine Institute provides minimally invasive spine surgery. Performed by board-certified surgeons,+ our procedures offer an outpatient experience with less risk of complication when compared to traditional open neck or back surgery. To learn more, contact our team today.

We are happy to offer a no-cost MRI review* to help you determine if you may be a candidate for one of our procedures.