Diagnostic Tests for Back Pain

Back pain has various causes, including accidents, injuries, and underlying health conditions; therefore, various tests are used in the diagnostic process. Physicians typically begin the process by asking questions, such as when the pain started and if anything makes it better or worse. They use this information along with the findings from a physical exam to decide which diagnostic tests should be ordered.

Tests that may be used to diagnose back pain include the following:

• X-rays
  X-rays can show problems with bones, such as alignment problems, arthritis, and fractures. Regular X-rays cannot show problems with muscles, the spinal cord, or discs.
• Computerized tomography (CT)
  A CT scan is a type of advanced X-ray. Discograms and myelograms use X-rays along with an injected dye to show any issues with spinal discs or other parts of the spine.
• Magnetic resonance imaging (MRI)
  In addition to problems with bones, MRIs can also show problems with muscles, ligaments, discs, and other tissues. Although MRIs provide more detailed images than X-rays, they are typically not the first test performed because of the high cost involved.
• Electromyography (EMG)
  An EMG can be used to identify nerve compression that could be caused by a herniated disc or a narrowed spinal canal. It can help differentiate issues with the nerves vs. issues with the muscles.
• Bone scan/bone scintigraphy
  A bone scan is a type of nuclear medicine test that can show problems within bones, such as tumors, infections, or fractures.
• Blood tests
  If an infection is the suspected cause of back pain, blood tests may be ordered.

Proper diagnosis of the cause of back pain directs the type of treatment that may relieve pain and restore function.