Diagnosis of back pain and spine diseases

Back pain occurs during each person’s life.

Frequency and acuteness of pain in each individual individual.

Back pain is often ignored until it becomes permanent (chronic) over time.

Before diagnosing and studying the causes of pain symptoms in the back, you must deal with all seriousness – this can in the future prevent complications of the disease and helps to choose an effective method of treatment.

The diagnosis of back pain is based on a thorough medical review, along with an analysis of medical history.

The examination of a patient with back pain should be carried out with scrupulous observance of all methodological rules.

Lack of doctor’s appointment or “under-examination” of the following issues may reduce the accuracy of diagnosis, and, therefore, question the effectiveness of the prescribed treatment:

In identifying complaints and analyzes, the answers to all of the following questions should be answered:

• Localization of pain, which the patient should specify precisely
• In what position the body most concerned with pain (lying, sitting, standing)
• What condition is forced to take the patient to reduce the intensity of the pain
• Is pain associated with movements? What exactly
• Where irradiates (spreads) the pain
• Duration of pain syndrome
• The pain has appeared for the first time or already was earlier?
• The pain arose suddenly or increases gradually?
• What physical activity or free movements preceded the pain syndrome?
• Was there no overcooling before pain?
• When the pain feels stronger – in the morning, in the afternoon, in the evening?
• Waking up at night by pain and rising from the bed with pain, decreasing or pain in the morning?
• Which bed is more comfortable to sleep – in hard or soft?
• Diseases that preceded the pain syndrome

With orthopedic examination (orthopedic protocol)

• Carefullypalpatethe entire pain area and especially the point given to the patient
• Determine irradiated pain when palpation of theupper pain point
• Establish the presence or absence ofmuscle hypotensionin the area of ​​the buttocks and lower extremities
• With a fixed pelvis, check the connection of the pain syndrome with themotion of the spine
• Exclude the pathology ofsacro-iliac joints

With neurological examination (neurological protocol)

• Palpitate the entire pain area, especially the point indicated by the patient
• Determine theirradiation of painwhen palpation of the upper pain point
• Find out the sensitivity and motor disturbances of thelower extremities
• Determine thesymmetry of the tendon reflexesand the degree of their response
• Determine the presence or absence ofmuscle hypotension
• When carrying aLasse sample, remember that it is not specific to the sciatic nerve, when not only (and perhaps not so much) the nerve, but also all the tendons, fascia,ligaments of the back of the legand the spinal cord area – the pathology of any of these pathological formations makes a positive test of Lassega
• ReviewX-rayof anatomical formations at the level of the highest pain point is mandatory in all cases without exception

Computer tomography (CT) and (or) magnetic resonance imaging (MRI) tomography is necessary in case of suspicion of the pathology of the sacrum, the adjacent branches of the iliac bones and the contents of the vertebral canal, changes in the vertebrae and intervertebral discs .

The choice of the required quality of radiotherapy (MRI and CT) should be determined by a physician who knows the capabilities and limits of the action of each of them. Not all MRI centers use high-resolution devices. The power of the device allows you to make high-quality pictures, where you can consider the pathology in more detail.