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There are lot of tests which help in diagnosis of back
pain,but which patient of backache should
be investigated and
what investigations should be ordered,
only the treating
physician can decide.
Lets classify backache into two
types
1.Acute back pains of less
than 6 weeks duration
2.Chronic back pains of more than 6
weeks duration
Most of the doctors agree that
acute back pain does not need
investigations unless it is accompanied by other factors like
weakening of one or both legs or loss of bowel and bladder
control,or the physician suspects some unusual cause. All the
chronic cases of back pains must be investigated to rule
out major diseases which may be harmful if left untreated.
The tests which may be ordered are:
1.complete blood counts including ESR, and Rheumatoid factor
2.serum calcium and phosphorus, serum alkaline phosphatase
and serum acid
phosphotase
3.Urine
examination
4.X Rays of lower back
5.Bone scan
All these tests are helpful in diagnosing infections of
spine ,fractures of vertebrae, osteoporosis , rheumatoid
arthritis ,ankylosing arthritis,tumours and their metastasis,etc
6.Nerve conduction studies
This test will identify the nerve which is getting compressed
in the intervertebral neural canal or in the vertebral column by the
prolapsed intervertebral disc .Once the level of compression is
confirmed and there are signs of progressive weakness of muscles,
surgery can be undertaken to relieve the compression.
7.Lumbar
discography
This test is used to evaluate the intervertebral disc
by injecting a dye into the disc so as to get
a complete idea of the anatomy of disc also to
determine whether that disc is causing pain or
not.
8.Computed tomography (C T scan)
9.Magnetic Resonance Imaging
(M.R.I) of lower back
These tests are used to
exactly pinpoint the lesion egg
metastasis,infections, prolapsed intervertebral discs, status
of apophysial joints,stenosis of intervertebral canal, para
spinal tumours and degenerative changes etc.
It has been found that abnormalities
noticed by imaging
techniques in backache patients are common even in normal
people, who have had no problem of backache , and so
these abnormalities are really the cause of backpain is yet to
be seen. Studies are already in progress to to prove the
significance of these abnormalities to backpain.
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