Patients provide detailed descriptions of their symptoms and medical background as the basis for diagnostic procedures. Based on this information, doctors usually have a better understanding of the cause of a patient’s condition.
The patient will be asked questions about symptoms and medical history prior to starting a physical examination. Typical questions include :
Information about current symptoms :
Does your pain get better or worse at certain times of the day?
When do you wake up or after work?
How far does the pain spread?
Are there any other signs and symptoms such as weakness or numbness at the same time?
How does the pain feel – painful, sharp, hard, dull, hot, stinging?
Activity level :
Does the person generally lead a more active or sedentary lifestyle? For example, do you have to sit at a desk for long periods of time or stand on an assembly line? Do you exercise?
Sleep habits :
How many hours of sleep does the patient normally get? Which posture is preferred for sleeping? Which type of pillows and mattresses is the patient using?
Which posture is comfortable or uncomfortable? Does the patient usually slouch or sit upright?
Has the person recently sustained any injuries? Has a prior injury happened that would be affecting you now?
Answers to these questions will give the doctor a more complete picture of the patient’s daily activities and point to more specific causes of back pain. The patient’s medical history is the most effective way to make a diagnosis.
A physical examination aims to further exclude potential pain sources. A standard physical exam for low back pain usually consists of a mix of the following procedures :
In order to detect any muscular stiffness, discomfort, or joint abnormalities, a doctor would palpate (also known as feeling) the low back.
Neurologic exam :
A motor exam, which comprises manual hip, knee, and big toe extension and flexion (movement forward and backwards) as well as ankle movement, will likely be part of the diagnosis. The patient’s response to light touch, a pinprick, or other sensations in the lower trunk, buttock, and legs will likely be tested as part of a sensory examination.
Range of motion test :
The patient can be instructed to bend or twist in particular ways. These actions are done to check for postures that exacerbate or reenact pain as well as to check whether particular motions are constrained by discomfort.
Reflex test :
To assess impaired reflexes and diminished muscular strength, the patient’s leg reflexes will be tested. A nerve root may not be reacting as it should if reflexes are impaired.
Leg raise test :
The patient is asked to lie on their back and lift one leg as straight as possible. If the leg raise test reproduces back pain, a disc herniation is suspected.
Generally, a doctor can determine the cause of low back pain by doing a medical history and physical examination. If the cause is not understood then a diagnostic imaging test is done, for example, X-ray, CT Scan, MRI and other tests if required.