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What to Expect from Diagnostic Tests
Posted: May 1, 2006
These are some tests your doctor may order to diagnose your back problem:
X-rays: Traditional X-rays use low levels of radiation to project a picture onto a piece of film (some newer X-rays use electronic imaging techniques). They are often used to view the bones and bony structures in the body. Your doctor may order an X-ray if he or she suspects that you have a fracture or osteoarthritis, or that your spine is not aligned properly.
Magnetic Resonance Imaging (MRI): MRI uses a strong magnetic force instead of radiation to create an image. Unlike an X-ray, which shows only bony structures, an MRI scan produces clear pictures of soft tissues, too, such as ligaments, tendons, and blood vessels. Your doctor may order an MRI scan if he or she suspects a problem such as an infection, tumor, inflammation, or pressure on a nerve. An MRI scan, in most instances, is not necessary during the early phases of low back pain unless your doctor identifies certain “red flags” in your history and physical exam. An MRI scan is needed if the pain persists more than three to six weeks, or if your doctor feels there may be a need for surgical consultation. Because most low back pain goes away on its own, getting an MRI scan too early may sometimes create confusion for the patient and the doctor.
Computed Tomography (CT) scan: A CT scan allows your doctor to see spinal structures that cannot be seen on traditional X-rays. It is a three-dimensional image that a computer creates from a series of two-dimensional pictures that it takes of your back. Your doctor may order a CT scan to look for problems including herniated discs, tumors, or spinal stenosis.
Blood tests: Although blood tests are not used generally in diagnosing the cause of back pain, your doctor may order them in some cases. Blood tests that might be used include the following:
- Complete blood count (CBC), which could point to problems such as infection or inflammation.
- Erythrocyte sedimentation rate (also called sed rate), a measure of inflammation that may suggest infection. The presence of inflammation may also suggest some forms of arthritis or, in rare cases, a tumor.
It is important to understand that medical tests alone may not diagnose the cause of back pain. In fact, experts say that up to 90 percent of all MRI scans of the spine show some type of abnormality, and sometimes the X-rays and CT scans of people without pain show problems. Similarly, even some healthy pain-free people can have elevated sed rates.
Only with a medical history and exam – and sometimes medical tests – can a doctor diagnose the cause of back pain. Many times, the precise cause of back pain is never known. In these cases, it may be comforting to know that most back pain gets better whether or not you find out what is causing it.
Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases
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