Diagnosis

Although most episodes of new back pain, as well as exacerbations of chronic back pain, clear up or return to a previous level of discomfort, a medical history and a brief physical examination is always necessary. Depending on the severity of the symptoms, how long they have been present, and any associated medical problems, additional evaluations may be necessary.

Medical History

The patient should be able to describe the back pain and its history in the following manner:

• Frequency, duration, and nature of the pain
• When the pain occurs
• What triggered the pain (such as lifting a heavy object)
• Conditions that make the pain worse, such as coughing
• Other relevant symptoms, such as morning stiffness, weakness, or numbness in the legs
• Previous episodes of back pain
• Previous back procedure or epidural
• Severity of the pain and how it affects the person's ability to perform everyday activities or work activities
• Any situation that relieves the pain
• Any history of injuries or accidents involving the neck, back, or hips
• Other medical conditions, such as arthritis or osteoporosis

A patient should report any serious health problems, symptoms, and concerns that may raise a red flag for a more serious condition. These include:

• HIV infection or AIDS
• Pain that is increasing in intensity and cannot be relieved
• Pain that increases when lying down
• Fever that is associated with the back pain
• Any new or worsening neurological symptoms, such as weakness in a specific part of the legs or feet
• History of cancer, or currently being treated for cancer
• Problems emptying the bowels or bladder, including incontinence
• Unexplained weight loss

Special state guidelines should be followed for worker's compensation patients.

• < Page
1 2 3 4
• >

Review Date: 04/07/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)