What is the Test for Back Nerve Pain?

Back pain is one of the most common reasons people visit their doctor. Up to 80% of adults experience back pain at some point in their lives. Back pain can range from mild and temporary to severe and chronic. When back pain radiates into the legs or arms, it often indicates irritation or compression of spinal nerves, a condition called radiculopathy or radicular pain. Diagnosing the cause of back nerve pain typically involves a combination of medical history, physical exam, and tests.

Medical History

When evaluating back nerve pain, doctors will ask about your symptoms, when the pain started, what makes it better or worse, and whether you have any other medical conditions. Information about any previous back injuries, surgeries, or treatments is also helpful. Doctors will want to know if you have symptoms like numbness, tingling, weakness, or changes in bowel or bladder function, which may indicate nerve compression. Questions about lifestyle, activities, posture, and workplace ergonomics can identify factors contributing to back and nerve pain.

Physical Exam

A physical exam is conducted to assess the back’s range of motion, check reflexes, and identify any muscle weakness, numbness, or radiating pain. Doctors will check posture and spine alignment. They will palpate the back to detect muscle spasms, tender points, swelling, or abnormalities. Moving the neck and legs in different directions can test the nerves. The doctor may perform a straight leg raise test to see if lifting the legs causes back pain, indicating nerve root tension.

Imaging Tests

If the cause of nerve pain is unclear after the history and physical, imaging tests may be ordered. These can visualize the spine and pinpoint sources of compression on nerves. X-rays can detect bone spurs, fractures, spinal instability, or loss of disk height. MRI scans provide detailed images of the spinal discs, nerves, ligaments, and soft tissues. CT scans also create cross-sectional images and are better for assessing bone changes. Diagnostic injections may be used to deliver anesthetic to specific spinal nerves. If this temporarily reduces pain, it indicates those nerves are involved.

Electrodiagnostic Tests

Electrodiagnostic testing assesses the function of nerves and muscles. Nerve conduction studies measure how fast electrical impulses travel along nerves. Electromyography detects abnormal electrical activity in muscles during rest and contraction. These tests can confirm nerve compression causing radiating back pain or limb weakness. Abnormal results indicate which nerves are affected and where they are being compressed along the spine.

Lab Tests

While imaging and electrodiagnostics evaluate the structure and function of nerves, lab tests can detect underlying conditions influencing nerve pain. Blood work can check for vitamin deficiencies, infections, inflammatory diseases, or problems with blood sugar, kidneys, or liver that contribute to neuropathy. Testing spinal fluid or imaging blood vessels may be warranted in some cases.

In summary, diagnosing back nerve pain involves a combination of the medical history, physical examination, imaging tests like x-rays or MRI scans, electrodiagnostic studies, and laboratory tests. These allow doctors to pinpoint which nerves are involved and what is causing compression or irritation of the spinal nerves, guiding appropriate treatment.