Diagnostic evaluation begins with the clinical examination. The health care provider should perform a detailed neurological and spine evaluation assessing for spinal nerve and spinal cord compression.

The key in the diagnostic process is to correlate the patient's history, symptoms, and any additional testing to determine the cause of the patient's pain.

Common diagnostic tests to aid in the diagnosis include:

  • Electroconductive tests are commonly performed to document the degree and severity of spinal nerve injury. The EMG and nerve conduction test (EMG/NCV) tests will exclude peripheral nerve compression such as carpal tunnel syndrome.

    See Electromyography (EMG)

  • Radiographs begin with an X-ray of the spine to determine the extent of arthritic changes and bone spur formation. With these films the physician may determine if destructive changes are present or further radiographic images are indicated.
  • Computerized tomography (CT scans) with myelography and/or MRI scans can provide details about change in the spinal architecture and the degree of nervous system compression. With these films the clinician will correlate clinical symptoms with radiographic findings and recommend the corrective course of action, often seeking the consultation of the spine surgeon.

As previously noted, the patient may have bone spurs present in the above imaging tests, but the bone spurs may not be the cause of the patient’s pain. Therefore, while the scans are a useful tool in the diagnostic process, they do not in and of themselves provide a diagnosis.