During the initial visit, your doctor will ask a series of questions in order to get a focused medical history and an exact description of your symptoms. Your doctor will also perform a physical examination. Taking a medical history and performing an exam will help the doctor identify the cause of your pain and also help rule out the possibility of a more serious condition.
The doctor will inspect your back carefully and check the range of motion in your back and legs. Your knee and ankle reflexes will be tested as well. Your doctor is looking for any indications that would suggest a more serious spinal problem such as a fracture, tumor, infection or genetic disease.
On rare occasions, back pain can be the symptom of a problem in another part of your body, and your physician will be on alert for any unusual signs of that. In the absence of any worrisome signs, a physician will diagnose the problem as nonspecific back pain, or sciatica if there is leg pain.
Some patients expect the doctor to order sophisticated medical tests, such as an X-ray, magnetic resonance imaging (also called an MRI) or computed tomography (CT scan). In fact, these tests are rarely helpful in diagnosing the specific cause of back pain. Oddly enough, a scan of a healthy back sometimes will show abnormalities or normal age-related changes which are not associated with back pain.
Furthermore, certain lumbar X-rays expose the patient to 150 times the radiation of a chest X-ray. Thus, X-rays are not recommended unless absolutely necessary. Unfortunately, like the common cold, the specific culprits of most acute back pain are elusive.
What Is Your Doctor Concerned About?
Your doctor’s primary concern is looking for “red flags,” such as fever or weight loss, which might indicate a more serious condition, such as infection or tumor. But it is important to keep in mind that such findings are rare. After a diagnosis of nonspecific back pain or sciatica, a physician’s next concern is to provide information that will help the patient relieve discomfort and allow him or her to resume daily routines.