Diagnosing Back Pain
When a doctor is diagnosing your back pain, observation is the first part of examination. That is, the competent practitioner will look at your posture, gait and other movements from the moment you walk into view, as well as while taking your history and examining you. Then you will probably be asked to walk a bit, bend over gently from the waist, and bend to each side. Pain and lack of mobility, if any, will be noted. So will alterations in the movement patterns, tremors, lurching or inability to perform normal movements.
While you’re lying face down on the examination table, the practitioner will perform a hands-on examination. They will palpate (lightly tap) your back to determine the extent of spasming. He or she will also probe your back, hips and buttocks to check for tightness, ‘knotted’ muscles, trigger points (small, extremely sensitive areas that are painful to the touch), and areas of referred pain. If lying on your stomach causes you pain, ask if you can lie on your side, or tuck a small pillow under your abdomen.
While you’re on your back, the practitioner will raise each of your legs. Sharp pain felt during this procedure, as opposed to the slight pulling sensation of a tight hamstring, may indicate a ruptured disc (It also tests the dynamics of your nervous system, known as neurodynamics or neuromechanosensitivity.)
You will also be asked to bring both knees towards your chest simultaneously. If you have a plain old backache, you’ll feel pulling and tightness in your lower back. If you have a ruptured disc, you may find this to be a relatively pain-free position. Your reflexes and neurological reactions will be checked with a small rubber hammer. Lack of appropriate knee-jerk response may indicate involvement of the nerve root. The same holds true if you show an abnormal reflex when tested in your Achilles tendon area.
The chances are about nine out of ten that the findings in your examination will be negative. From your viewpoint, however, the medical word ‘negative’ means ‘positive’ – no serious disease, neurological impairment or structural abnormality.
Mail this post
Tags: Diagnosing Back Pain
