Medical History of Back Pain
The first thing doctors do to evaluate back pain is to ask questions about the nature of the pain and how the patient has felt in the past. All of these elements are laid down in medical history. Still, most cases are difficult to assess because most patients do not display alarming or very noticeable symptoms that differentiate types of back pain and provide a clue for the diagnosis. Thus, around 85% of these patients are diagnosed as non-specific back pain after the initial evaluation. That’s because doctors initially didn’t find any significant clue to lead to the diagnosis.
Still, there are some characteristics of back pain we can evaluate, and one of the most important is the duration of the symptoms. This can break down back pain into acute, subacute, or chronic. Acute back pain refers to a short span of symptoms, usually not longer than a few days. Subacute back pain refers to lingering or returning pain affecting patients for 4 to 12 weeks. Chronic back pain is diagnosed when the symptom stays for a very long time, usually more than 12 weeks.
Another important aspect is the severity of pain, which is commonly evaluated using a numerical scale or a visual analog. Doctors will also ask you if you would describe your pain as aching, burning, or lancinating and if you experience numbness, tingling, or electric shock sensations. The circumstances that trigger or worsen back pain are also important, especially if we are talking about trauma or a car crash.
If you have been looking for an answer for your back pain problems and have had studies done in the past or a previous diagnosis, it is also important to share all that information with your doctor. If the pain is subacute or chronic, it is also essential to talk about changes in the presentation of pain throughout time. Has it become worse as time goes by?
Another important part of the medical history is evaluating any previous history of cancer. Most types of cancer can metastasize to the bone tissue and cause back pain. The most common are lung cancer, breast cancer, renal cell cancer, and prostate cancer.
The doctor may also need to know about recent infections or infectious symptoms such as fever. This is important to consider if you have had recent surgical procedures or spinal injections.
Finally, doctors will also evaluate the patient’s neurologic system for any sign of nerve compression. These signs include bowel control changes, bladder-related problems, urinary retention, fecal incontinence, gait instability, weakness of the limbs, numbness, and tingling sensations. The nervous system should also be assessed regarding psychological distress, psychiatric problems, and substance abuse.