Diagnostic tests for back pain — what to expect when you consult with a physician

A physician may perform several different diagnostic tests to determine the cause of your back pain. During your first visit, your physician will likely review your medical history and perform a comprehensive physical examination. As part of this assessment, your physician may complete a number of tests to learn more about your symptoms and find out what might be causing them. Once this process is complete, your physician can then order any additional tests (e.g., imaging scans or diagnostic injections) that he or she might need to make a final diagnosis.

In-office diagnostic tests for back pain

When you describe your discomfort to your physician, he or she might ask how long you’ve had the symptoms, whether you’ve noticed anything that makes them better (or worse), whether you’ve had any previous back pain diagnoses and what you’ve been doing at home for treatment. He or she might then perform several range of motion tests to more fully understand what you are experiencing. For instance, your physician may ask you to bend over and touch your toes, raise both hands over your head, turn from side to side with your feet firmly planted on the floor or walk around the exam room. Additionally, your physician will likely feel your spine to see if he or she can manually identify any potential abnormalities.

Diagnostic injection tests for back pain

Several types of injections may also be used during the diagnostic process. These include:

  • Selective nerve root blocks. Many nerves enter and exit the spinal canal. If a nerve (or nerve root) is compressed by a herniated disc, bone spur or other similar condition, it can cause significant pain. A small amount of numbing medication can be injected into a nerve that is suspected to be under pressure. If the result is immediate pain relief, your physician can pinpoint the specific part of your spine that requires treatment.
  • Facet nerve blocks. Facet joints allow the spine to bend and twist. A small amount of numbing medication can be injected into one or more of these joints to determine if the pain is related to joint damage.
  • Medial block injections. The medial nerves are small nerves that branch out from the facet joints and carry pain signals to the brain. A small amount of anesthetic medication can be injected directly into one or more of these joints to determine if they are causing back pain.

While injections can be very helpful to a physician for pinpointing the part of your spine that requires treatment, you may still need one or more diagnostic tests to determine the exact cause of your back pain. CT scans, bone scans, MRIs and X-rays are all options that your physician may consider based on the results of your previous diagnostic tests.