A major cause of absence in the work place is back pain. The intensity and symptoms of back pain differ greatly. Due to these variations, accurate diagnosis is sometimes difficult to get. However, some spinal diagnosis are direct.
Majority of the cases related to back pain do not need medical attention. Most treatment can be done through self-care or over the counter medication. It is very crucial to come up with accurate diagnosis. Different diagnosis often need different management tactics. The sooner the right treatment is found, the better it is so that the patient can enjoy a healthy active life.
Types of Diagnostic Imaging Technologies for Back Pain
Numerous types of imaging problem-solving technologies and procedures are available to help precisely diagnose the structural lesion that is triggering back pain.
Injections for Back Pain Relief and Diagnosis
Certain injections are usually used for either back pain aid or analytic resolutions.
As X-rays are easily available and not that expensive, they are usually the very first procedures of imaging that are used. The X-rays result will be used to decide the back pain management strategy that may be established or progressively more refined imaging revisions may be finalized to accurately explain the basis and level of the functional structure that brings about the pain.
X-rays of the spine are effective for revealing damage to bones either from a fall or trauma. They are however not of assistance for repetitive back pain that is not caused by trauma.
X-rays come in handy in ruling out back pain caused by fractures, tumors or instability. The precise detail of the bone structure greatly helps in ruling out these back pains.
The X-ray shoots an X-ray beam through the section required and the calcium blocks the X-ray beam from penetrating enabling the bone’s image to be picked as a shadow in the other section of the victim on a film. X-ray however cannot capture an image where there is no calcium i.e. nerve roots and discs, ruling out diagnosis for nerve pinching causes. Pregnant women should not undergo X-rays.
Computerized Tomography (CT scan)
CT scans are similar to X-rays but are more detailed. A computer reformats the image into many cross sections of your spine. This is then repeated severally in multiple altered intervals giving a precise bony feature. Imaging back pain brought about by conditions like lumbar disc herniation and lumbar spinal stenosis are hence enabled using multiple views. Fractures are easily evaluated through CT Scans.
Since X-ray beams are still used in this process, nerve roots are not visibly shown and can result in missing smaller disc herniation. CT scans are not to be performed on expectant mothers.
Computerized Tomography (CT scan) with Myelogram
To get clear nerve details, myelogram is combined with CT scan during a back pain diagnosis. The myelogram however adds some more risk and cost to the computerized tomography scan but gives important information on the nerve roots.
A myelogram involves injecting radiographical impervious dye, this dye is then picked up by X-ray beams to the sac surrounding the nerve roots causing the nerve roots to light up.
A CT scan trails and displays how the nerve roots are being affected by the bone. It is a very effective nerve impingement test and can detect very delicate injuries. CT Scans cannot be used on expectant mother because X-ray beams are used.
Patients with past migraine headaches might get spinal headaches as a result of the presence of myelogram involved in the CT scan. This will however go away after 2 to 3 days after taking in lots of fluids and getting enough rest. If the headache persists, a little blood can be drawn from the arm of the patient (antecubital vein) which will then be injected in the epidural space at the back (blood patch), placing pressure over the spot where the spinal fluid is leaking taking care of the headache.
An EMG looks into the electrical movement in a nerve root and can sometimes be suggested to patients with back pain. What usually happens is that after repeated pressure to a nerve root, the muscle that the nerve connects to gets impulsive contracts. This eventually results in slow-moving electrical conduction in that nerve.
EMG sometimes helps to differentiate between nerve degeneration and nerve root compression.
To determine the nerve that is compressed, small needles are placed into the muscle. Though it is a little bit painful for the patient, there are no risks involved. This test is however not so reliable.
Discogram tests determine the structural source for lower back pain in patients. This process is most often used to ascertain if degenerative disc syndrome is the cause of a patient’s agony, also referred to as discogenic low back pain. Discogram is also carried out to help in preoperative planning in candidates undergoing lumbar spinal fusion.
A needle is usually inserted at the back of the patient in the middle of his or her disc by a discographer. Radiographic dye is injected inside the disc. If the patient feels pain (concordant), the disc is determined to be the source of the patient’s agony. If there is no pain experienced (discordant), it can be concluded that even if the MRI scan might show a degenerated disc, it is not the cause of the pain.
For proper diagnosis, the patient should remain awake during the process to maintain communication on the kind of pain being experienced as a result of the injection. Anti-inflammatory drug should not be administered as the discogram injection is not a pain reliever. After the discogram is over, a numbing manager (lidocaine) can be administered. CT scan procedures generally check the disc’s composition.
Disc space infection is the only risk involved during the procedure though it is very rare. The needle passes next to the nerve causing a slight nerve root injury.
To rule out spinal tumor and occult fractures that X-rays can’t catch as a result of inflammation, a bone scan procedure is necessary. A small amount of radioactive marker is injected into an intravenous line (IV). After 3 hours, a scanner is placed over the patient and concentration of radioactive marker shall be seen in areas with great bone turnover.
A bone scan has remarkable results as it detects infections, tumors and very small fractures as these disorders end up in enormous bone turnover. It can also check for fracture compression if a vertebral body is aged or new. Aged fractures don’t light up, but new ones do.
Bone scans are not able to differentiate what an injury characterizes, thus it can’t tell an infection, a tumor or fracture apart. Therefore, a CT scan or MRI should follow to better represent the injury.
Dual Energy X-Ray Absorptiometry (DEXA scan)
A DEXA scan is used to get a detailed evaluation of a patient’s possibility of fracturing by spotting osteoporosis, a thinning in the bones caused by old age and likely source of back pain.
DEXA scan will only take 10 minutes of your time and is linked with little radiation exposure. Calcium content in your bones is measured by the low energy X-rays that go through your bones. If osteoporosis is detected, treatment will be prescribed to minimize the risk of fracturing a vertebral body.
Correct medical analysis of back pain in patients compares findings of tests like MRI, with the patient’s precise symptoms together with the physicians report from a thorough physical procedure.
Diagnostic tests approve a structural injury pointing to any abnormality as the result of pain. They are very helpful in diagnosing and developing suitable treatment strategy.