Diagnosing the cause of back pain

Diagnostic tests Medical history and physical examination Radiological texting Neurophysiological testing Blood tests Other diagnostic tests

Medical history and physical examination

What it is:

Medical history consists of an interrogation of the patient to obtain relevant information on past medical details, symptoms, and pain characteristics and evolution from onset.

Physical examination by a doctor essentially consists of:

1. Having the patient adopt certain postures and movements, and
2. Subjecting the patient to specific maneuvers to evaluate sensory loss, strength and reflexes.

What it allows:

Obtaining a clinical history and performing a physical examination is fundamental to establish the cause of pain, and above all, to determine the severity of the dysfunction. These may determine:

• The need to undertake more expensive or uncomfortable diagnostic tests such as MRI or electromyogram.
• Their true usefulness, when evaluating the concordance of the test results with the medical history and physical examination.
• The patient's evolution through time. For example, in a patient with disc herniation,, the disappearance of nerve compression signs during physical examination reflects a good evolution, although there may be no visible changes on the MRI.
• The most adequate treatment, since the same pathology should be treated differently, according to the outcome of the physical examination.

Risks:

There are no associated risks. It is the simpler and most inexpensive diagnostic tool, since it only requires time and expertise from the doctor.

Indications:

The existing recommendations based on scientific evidence coincide in always indicating a medical history and physical examination on the first visit of a patient with back pain.