Diagnosis of Chronic Low Back Pain
Now, let’s talk for a few minutes about chronic low back pain. Now, Dr. O’Connor, can you tell us what the term means?
Dr. O’Connor
Sure, Ty. Chronic back pain is, quite simply, back pain that lasts for more than 12 weeks. The term chronic does not refer to the severity of the pain, but rather the duration of the symptoms. The cause can be difficult to determine, but keep in mind that chronic back pain does not necessarily mean that there is any damage to the back. But the persistence of the back pain does indicate that a medical evaluation might be necessary.
Ty
I see. And, how is chronic back pain diagnosed?
Dr. O’Connor
Well, in most cases, the provider will start by taking a focused medical history, followed by a thorough physical exam to determine the likelihood of an underlying condition that could be causing the back pain. Most people would then be prescribed appropriate self-care treatments, and asked to return for a second examination after a specific period of time. Now, if the self-care options have not proven effective, the patient may then undergo some specific tests.
Ty
Do these tests involve x-rays or scans?
Dr. O’Connor
Excellent question, Ty. For most people with chronic low back pain, imaging test will not be required. In fact, imaging tests are recommended only when a serious underlying condition is suspected or when a neurologic deficit is present. Now, a neurologic deficit is a problem in nerve, spinal cord, or brain function that affects a specific part of the body, causing things like muscle weakness, numbness, or loss of bladder or bowel control.
Ty
I see. So what sort of tests might a physician suggest?
Dr. O’Connor
Well, both MRI and CT scans are possibilities. MRI, which stands, of course, for magnetic resonance imaging, is usually preferred and provides good images of soft tissue. However, it’s important to know that in 90% of cases, the cause of low back pain can’t be determined. And, abnormal findings on MRI usually have nothing to do with the back pain. Keep in mind that serious spinal conditions are very rare, occurring in less than 2% of cases.
Ty
Okay. Thank you, Dr. O'Connor. We’ll talk more about the treatment of chronic low back pain when we come back.