A thorough history to evaluate
low back pain includes an assessment of:
Your doctor or nurse may also give you a written
questionnaire to screen for
depression or to assess how low back pain is affecting
your life, to rate your job satisfaction, and to describe your support system
at home and at work.
During the physical exam, your doctor will
ask you to do a series of movements while you stand, sit, and lie down. This
makes it possible to assess muscular and sensory problems contributing to your
low back pain. The physical exam will also include:
The results of these tests will help your doctor see
whether your back pain and other symptoms are related to pressure on a nerve
and which nerve or nerves may be compressed. Your doctor will use this
information to help determine what type of treatment is most likely to be
The history and physical exam
are the first part of the work-up for low back problems. Your doctor may change
or skip some of the tests to avoid further injuring your back.
The history and physical exam for low
back pain may provide these results:
History does not reveal an obvious cause of the low back
A physical exam does not cause the same type of pain, muscle
weakness, or nerve-related symptoms that you have been having.
Your doctor may recommend:
The medical history and physical exam are likely to
distinguish between a low back problem related to a muscle strain or overuse
and one that is caused by pressure on a nerve or another more unusual
Pain can be related to both
physical and emotional causes. When you're stressed, for example, muscle
tightness or spasm can set into your back, causing pain or making it worse.
Similarly, troubling emotions can make pain worse. If you or your doctor have a
sense that your pain is being caused or made worse by stress, anger, or other
difficult emotions, be sure to plan for specialized treatment.
Cognitive-behavioral therapy and
biofeedback are two types of treatment that can give
you tools for managing your pain.
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December 14, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Robert B. Keller, MD - Orthopedics
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