Diagnosis-Evaluation
Terms you should know
Trauma : Injury
Tumor : Growth of tissue.
Range of motion : How much a particular joint can move.
Tenderness : Pain produced by pressing the affected part.
Diabetes : When the blood sugar levels are higher than the normal values.
Aneurysm : Localized dilatation of a blood vessel
Intravenous contrast : A dye which is injected in the body through the veins. This allows better visualization of tissues and blood vessels.
Fetus : Developing child inside the mother’s womb.
Cauda equina : Lower end of the spinal column that resembles a horse’s tails.
Spinal cord : The column of nerve tissue that runs from the brain to the lower back through the spine.
It is often difficult to pinpoint the cause of back pain since there are so many possible causes . Your doctor will first ask you a number of questions, the most common of which are listed below :
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Is the pain on one side only ?
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Is it mild or severe ?
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Did the pain begin recently or it is a long-standing pain?
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Did the pain begin suddenly ?
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Is the pain persistent or
episodic?
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If episodic, how long does each episode last ?
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How often does the back pain occur?
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Does the pain occur only at night?
- Is there any psychological stress ?
- What is the occupation ?
- In what types of recreational activities / sports do you participate?
- Does the pain go into the hip, leg or feet ?
- Is the pain worse while coughing?
- Does the pain get worse with straining, lifting, or similar activities
- Does exercise or rest relieve the pain ?
- What other symptoms are present?
- What treatment have been used so far ?
Think about these ahead of time so you can answer them easily.
The quality of pain, its distribution and modulating factors are helpful in determining the cause of backache.
Sudden onset : Particularly if associated with trauma, suggests bone or soft-tissue injury.
Slow Onset : Suggests a cause like tumour.
Episodic or colicky pain : Suggests a problem in the abdomen.
Exercise : Pain that worsens with exercise, especially walking, suggests osteoarthritis or lumbar spinal stenosis (narrowing of the canal through which the spinal cord passes.)
Coughing or sneezing worsens the pain : Suggests compression of the nerve.
Physical examination involves a detailed examination of the body with particular emphasis on the back. This involves :
- Testing the range of motion of the spine.
- Determining the area of tenderness.
- Assessing the strength of the lower limb muscles.
- Testing the power, tone, sensation land reflexes in the lets.
