Figuring Out Your True Back Pain Diagnosis
August 5, 2010
by: Sylvia Marten
You may be asking yourself or others about the most sure-fire ways to treat certain back conditions, and what to expect after a particular treatment. However, the important first step that often seems to be overlooked is to know your true back pain diagnosis (which is harder than it sounds).
Obviously, even the best treatments for back pain won't do much good if the diagnosis is not correct. Here are a few pointers about how to know and understand your diagnosis:
Know the Precise Cause of Your Back Pain
Figuring out the cause of your pain is different from finding out what's anatomically wrong with your back. For example, you may have a degenerating disc that shows up on an MRI scan, but that may not be the cause of your leg pain. So if you get treated for the degenerating disc, the actual cause of your leg pain may not have been treated and you would not feel any better - just frustrated by the time, expense, pain, etc. involved with treatment. Your leg pain may actually be caused by an inflamed nerve root that requires treatment. For more information, see the following article:
Figure Out What Type of Health Practitioner to See
This is also sometimes harder than it sounds. Different types of health practitioners tend to have different areas of expertise. For instance, a physiatrist will specialize in physical rehabilitation to treat back pain, but may also prescribe medications, do injections, or perform other back pain treatments as a means to alleviate your pain and make you able to progress with rehabilitation. Moreover, within each specialty, some health practitioners may or may not specialize in spinal disorders (some may specialize in joint disorders, neurological conditions, stroke rehabilitation, etc.) We think it's best to see one who specializes in spine medicine. We also recommend that your physician be board certified or board eligible. For more information, see the following article:
Spine Surgery Should Never Be a Guess
Spine surgery is not done on an exploratory basis. The spine surgeon should know what the cause of your pain is prior to the surgery. And this is not necessarily the same as knowing what is anatomically wrong with your spine, as you can have disc degeneration or other anatomical lesions that show up on the scan but are not causing pain. Conversely, some causes of pain will not show up on an MRI scan and cannot be corrected with spine surgery. Many practitioners believe that one of the most common causes of failed back surgery syndrome (continued pain after surgery) is an improper diagnosis prior to the surgery. For more information, see the following article:
MRI Results Are Not the Diagnosis
Always remember, your MRI findings are not necessarily the cause of your back pain or neck pain. Many people over the age of 30 have a spine that is showing some wear and tear, but this does not mean that they are in any pain. Studies have shown that many people with no pain or other symptoms often have some sort of disc problem show up on an MRI scan. In fact, the surgeon will usually know what he or she is looking for (based on your physical exam and medical history) prior to even ordering an MRI scan. The purpose of the MRI scan is mainly to help confirm the diagnosis and to help the surgeon plan the surgery. For more information, see the following article:
Don't Worry Too Much about Terminology
Many health practitioners use different diagnostic terms to mean the same thing (such as a slipped disk or herniated disc), or use the same term to mean different things (such as bulging disc, which can refer to degenerative disc disease or a herniated disc). There is little agreement in the medical field as to the precise definition of any of these terms. If you hear your diagnosis referred to in different terms by different practitioners, you may question what the real diagnosis is. Rather than focusing on the terminology that refers to anatomy, we recommend focusing on the clinical diagnosis - which is the cause of your pain. For more information, see the following resources:
- What is a Herniated Disc, Pinched Nerve, Bulging Disc...?
- The Spine-health Glossary can help clarify the meaning of many terms
Causes and treatments for back pain involve a surprisingly complex set of factors, and unfortunately the experts don't agree on many aspects of back pain. That's why it's important that you continue to educate yourself on your own condition and treatment program - as no one is more motivated to manage your condition than you. Finding the exact cause of your pain and the correct way to treat it is the best way to rehabilitate your back.