Imaging and Diagnostic Testing
Despite what patients may think about, back pain diagnosis usually does not require any diagnostic imaging test. Actually, in some cases, diagnostic imaging throws results that do not strongly relate to the symptoms. Sometimes we have patients with a very abnormal imaging study and no pain at all, and the opposite is also true.
However, studies are needed to rule out infection or malignancy in some cases. Nerve conduction velocity and electromyography testing are also useful in some cases to detect radiculopathy and differentiate acute and chronic conditions. It may also help doctors localize the exact nerve root involved in the problem.
Imaging studies are only recommended in some cases of subacute and chronic back pain and when trauma is a likely trigger. It is also recommended in patients with severe or progressive neurologic problems associated with back pain, those with signs of spinal stenosis, and candidates for surgery. In some cases, X-rays are enough for the diagnosis. In others, computed tomography scans or magnetic resonance imaging are preferred. MRI is more commonly used in patients with a nervous system alteration and those with known radiculopathy.