Back Pain Diagnosis

In order to diagnose back pain for relief treatments, generally health care professionals begin by ordering a medical history and physical examination. A look at each of these in depth can shed some light into what to look for and how to find relief from pain. Then we’ll look at specific diagnostic tests, and where to go to follow up and get treatment.

No matter whether the patient has acute back pain, which is what most have and recover from with around a 4-week period, or chronic, recurring pain episodes, a medical history helps patient an doctor become familiar with one another in confidence to begin or continue a treatment program together. The medical history delves into these areas of the person seeking pain relief: family medical history and personal and work history with regards to back pain episodes and related symptoms and issues, psychological and psychosocial factors, referral source(s) for evaluation and treatment, education on the subject and treatment options, assessment throughout their working together on pain relief treatment and treatment outcomes.

Spinal Stenosis, Facet Syndrome and Herniated Disks

FACET SYNDROME

Similar to pinched nerves symptoms, this is believed to be associated with pain in the back’s side joints and the main cause of up to 20 percent of back pain cases, with buttocks and upper leg pain increasing with long-term standing, and when switching sitting / standing / lying positions. An injection of local anesthetic into the facet joint helps determine the diagnosis. However, since the anesthetic relieves the pain at the same time and is used as a short-term solution, an x-ray doesn’t help with imaging the pain results. Recommended treatment includes rigorous lumbar activities and body mechanics exercises to learn proper or more beneficial posture and movement techniques.

Herniated Disk

Causes of Back Pain

Most references to back pain focus on lower back pain in the lumbar spinal region. However, back pain causes in no particular order are:

    Accidents or injuries leaving muscle pain

    Osteoarthritis with deteriorating cartilage

    Osteoporosis with bone loss / fracture

    Fibromyalgia

    Major conditions like cancer

Muscle, ligament and tendon problems are generally at the root of the pain problems along with some weakness in the lower back. Other body parts in the region can also be associated like bones and small joints.

When no specific cause is apparent, the term NSLBP (nonspecific low back pain) is used. Any number of reasons for this pain can include degenerative disk disease, psychological issues, systemic disease, facet syndrome (similar to pinched nerves symptoms), herniated disk, spondylolisthesis or the forward displacement of one of the lower lumbar vertebrae over the vertebra below it or on the sacrum. Other factors could be spinal stenosis or constriction or spondyloarthropathy (disease affecting spinal joints).

Backpain Types and Terminology

To learn more about specific types of back pain, it helps to identify the type of pain present, similar to a doctor visit when asked, “Is it a stabbing pain or dull ache?” These are helpful healthcare term associated with back pain

ACUTE -Most back pain sufferers fall into this category. With acute low back pain, certain movement ranges for activities may be limited due to pain. But most people recover within about four weeks on their own.

CHRONIC – Also referred to as recurrent low back pain or when acute pain episodes recur for more than three months. This is most generally when medical treatment is sought. Note one can suffer acute and chronic pain at the same time. As secondary health problems be involved. In other words, chronic pain sufferers can be susceptible to acute pain.

ONSET – When the pain began. Acute onset means it occurred suddenly. Insidious onset means it gradually developed over a period- could be days or longer.

FACT OR MYTH- ABOUT BACK PAIN

Back pain is the number one disability for those under age 45. And it runs second, after the common cold, as the top reason for visiting a healthcare provider in the United States.

There is nothing really wrong with you. Myth! Chronic pain sufferers report that doctors generally tell this to about 90 percent of them and it is incorrect. In reality, the majority of low back pain cases or some 90 percent generally come from an unknown cause, like an infection or a particular injury. And the duration of the pain runs generally from four to six weeks.

“People dont die from chronic back pain.” Wrong! The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide, which does happen from time to time.

Namenda and Other Medications

Another medicine, called Namenda, has recently been approved for use in the U.S. This medication has a different action than the acetylcholinesterase inhibitors and the two types of drugs may be used together, at the same time. This may increase the effectiveness of therapy.

All of the FDA-approved treatments now available only provide relief of cognitive symptoms; they do not attack underlying disease. A recent study found that patients with mild Alzheimer’s disease who take a drug called Flurizan were able to slow the disease-related decline in their activities of daily living (such as eating and dressing) by about 67 percent when compared with people on placebo.

Flurizan is the first of a new class of drugs known as selective amyloid beta-owering agents, which are intended to affect the suspected underlying cause of the disease, a build-up of beta-amyloid protein.

The cholinesterase inhibitor, Cognex, is rarely used anymore due to serious liver side effects and the need for frequent blood testing.

In a trial involving eight people with mild to moderate Alzheimer’s, researchers at Weill Medical College of Cornell University are trying to harness the body’s immune system to fight Alzheimer’s. In this trial, intravenous immunoglobulin (IVIg) seemed to increase the levels of anti-beta-amyloid antibodies in the blood to a greater degree than seen before resulting in an average 45 percent decrease of amyloid. Six of the eight patients experienced improvement in cognitive function and none of the patients had declining function.

Acetylcholinesterase Inhibitors

Alzheimer’s causes the destruction of neurons (brain cells). It also destroys the important chemical messenger acetylcholine, which is responsible for memory and other cognitive skills. While no drug has yet been shown to completely protect the brain against the effects of Alzheimer’s, drugs that protect acetylcholine from destruction appear to hold the symptoms at bay for a while longer. These medications are known as acetylcholinesterase inhibitors (AChE inhibitors) and include :

    Aricept,
    Exelon, and,
    Reminyl.

For the acetylcholinesterase inhibitor drugs, the dose of medication is started low and gradually increased to the recommended level. Tolerance (the drug no longer provides the same benefit) may occur. It is also important to know that these medications are expensive, averaging in the neighborhood of $130 per month. Your insurance or health cover may or may not cover the costs of this drug.

Reminyl Warning: in April 2005, Reminyl’s label was changed to include information about the deaths of 13 elderly patients who were taking the drug during a study. The deaths were due to various causes, including heart attack and stroke.

Alzheimer’s Drugs and Medication

Modern drugs can help sooth agitation, anxiety, depression, and sleeplessness, and may also help boost participation in daily activities. Newer medications are also becoming available that can improve or preserve thinking skills, at least temporarily.

Please note: Regular reassessment is required while you are on any of these medications. This helps doctors determine if the medicines are being tolerated without troublesome side effects. These regular visits are also to make sure the patient is responding to the medication appropriately.

It is important to note that consumption of some nutritional supplements or medications can have serious side effects or interfere with other prescribed medications. Please consult with your doctor before using any nutritional supplements or medications.

Alzheimers and Aspirin