Testing For Back Pain

Medical Evaluation and Diagnostic Testing procedures should be performed prior to beginning any treatment in order to determine the treatment process that will be most effective. The following describes some of the evaluation testing procedures that can be performed to help confirm the cause of back pain.


The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. The following are used to test for the cause pain:

X-RAYS
An X-Ray provides an image that can be used to evaluate bones, joints and degenerative lesions in the spine.
CAT SCAN (CT)
Used primarily when problems are suspected in the bones or when a patient can’t obtain an MRI
MAGNETIC RESONANCE IMAGING (MRI)
The most reliable and detailed image used to evaluate the "soft tissue" elements of the spine. ie. Discs, Joints, Nerves, Other Soft tissues.
MYELOGRAM
A radio-opaque dye is injected into the space around the spinal cord and then the area is x-rayed.
DISCOGRAPHY
Discography is a diagnostic procedure used to determine the level of the painful disc.
EMG/NERVE CONDUCTION
The EMG/Nerve Conduction Study is utilized to determine the degree of pathology or loss of function in the affected muscles and nerves.
BONE DENSITY
Bone density testing is fast, painless, and noninvasive. Specific bones can be scanned with the equipment to determine the levels of bone density, calcium deposition, and bone loss. The entire test normally takes only minutes.
BONE SCAN
A Bone scan in Nuclear Medicine is a procedure which involves two steps:

The patient is asked to arrive 3 hours before their actual scan to receive an injection of a small amount of radioactive tracer that is "tagged" to a calcium like material. Usually the tracer is injected in a vein in the arm of the patient. In some instances, other sites of injection are used especially for those patients that had difficult veins to find. The "radiopharmaceutical" agent has no side effects and because of this, the patient can be released from the department for 3 hours to give the calcium time to circulate and be taken up by the bone. There are no dietary restrictions so the patient may eat before and after the injection.

After the three hours has elapsed, the patient returns to the Nuclear Medicine department for their scan. The patient is placed on a table and a head to toe scan is performed by a "gamma camera" measuring the rate of absorption of the radioactive tracer agent. An abnormal rate of absorption can indicate the presence of a disease process.

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