Getting an accurate chronic pain diagnosis is essential to creating the most optimal, highly customized treatment plan for the individual. Depending on the severity and cause of pain, individuals could require various pain specialists/therapists combined with a primary physician. These could include:
- Physical therapist
- Pain medicine specialist
- Orthopedic spine surgeon
Chronic Pain Diagnosis
Over time chronic pain symptoms can change or alter and need reevaluation. This could mean having to adjust treatment and management but that is exactly what it is, an adjustment to the treatment plan flowing with the symptoms as they come and go while keeping to the objective of. Chronic pain diagnosis entails a series of tests, as well as, a full review of symptoms and medical history. A doctor will ask a series of questions concerning symptoms and pain triggers. These questions could include:
- When did the pain begin?
- Describe and rate the pain, is it shooting, electrical, burning, throbbing, dull, or sharp?
- Has there ever been an injury at or around the problem area?
- What activities/actions/movements relieve and worsen the pain?
- Is there a history of mental illness, like depression or anxiety?
Tests will be ordered to identify physical/non-physical causes that could be the cause or contributor. Possible tests include:
Blood tests are used in the diagnosis of infections and inflammation. Individuals with infection/s or inflammatory disorders have high levels of white blood cells and inflammatory reactive substances like C-reactive protein. Blood tests also help determine the presence of rheumatoid arthritis, gout, or cancer. If rheumatoid arthritis is present, the blood analysis will show positive results for proteins known as rheumatoid factor.
Urinalysis is commonly used to check for gout. This is a type of arthritis that causes high blood levels of uric acid. A doctor may order a urine test for a patient using prescription pain meds.
A doctor inserts a needle into the lower back and a sample of cerebrospinal fluid is collected. Cerebrospinal fluid is clear and protects the brain and spinal cord. A cerebrospinal fluid analysis helps to diagnose disorders of the central nervous system and certain cancers.
A musculoskeletal exam looks at posture, joint mobility, muscle stiffness, tightness, and swelling in or around the area, as well as the rest of the body. An example is a diagnosis of carpal tunnel syndrome. A detailed spine examination is done to identify deformities and moving/walking posture. A neurological examination is used to check:
- Muscle strength
- Touch reaction
- Overall sensation
A neurological exam can also be used to test:
Imaging provides detailed images of the body’s organs and bones. Doctors use these to:
- Spot fractures or inflammatory alterations in the bone/s
- Focus on details of a bone and surrounding structures
- Differentiate between growths, infections, or fractures
- Identify nerve/s injury or damage
X-rays are standard in the diagnosis of fractures. An arthrogram is an x-ray that uses a contrasting agent to check and identify joint disorders.
Magnetic resonance imaging uses a magnetic field and radio waves to create detailed images. Magnetic resonance imaging helps in diagnosing:
- Low back pain
- Pelvic pain
- Peripheral neuropathy
EMG – Electromyography
EMG’s are used to diagnose disorders of the muscles and nerves. Electrical activity in the muscles is recorded to see how the impulses/electrical signals are transmitting from the nerves to muscles.
An EMG could be required if an individual has:
- Muscle weakness
- Muscle pain
Electromyography is also used to identify conditions that can cause chronic pain like:
- ALS – Amyotrophic lateral sclerosis
- Carpal tunnel syndrome
- Radiculopathy from pinched nerves in the spine
- Muscular dystrophy
A nerve conduction study measures the speed of electrical signals passing through a nerve. It can identify:
- Carpal tunnel syndrome
- Herniated disk disease
- Sciatic nerve injury/damage/abnormality
A doctor can order both an EMG and NCS in combination.
Back Pain Chiropractic Care
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