Introduction
Since back pain can have many different causes, it is very important to carry out a detailed diagnosis to identify the underlying problem of back pain in order to be able to treat it successfully afterwards. This diagnosis of back pain includes both a thorough anamnesis (conversation) as well as a physical examination and, if necessary, apparatus-based procedures.
Anamnesis for back pain
Since different causes of back pain are possible, the medical history is particularly important. Many back pains have psychological reasons (see: Back pain and psyche) or are at least intensified by psychological complaints, so above all value should be placed on a social anamnesis. The occupational history also plays an important role in the diagnosis of back pain, in order to determine whether the patient is exposed to severe stress in his or her job, e.g. has to remain in a standing or sitting position for a very long time or has to lift heavy objects.
It is also important in diagnosing back pain to define it precisely, precisely because there are so many different forms. It is important for the physician to ask the patient’s doctor. It is a great help if a patient keeps a so-called “pain diary” before his medical diagnosis, in which he lists all these points if the back pain is plaguing him. In this way, it is often possible to rule out some of the symptoms and to test more specifically for those diseases that are still possible.
- When the back pain occurs,
- How often,
- At which point exactly,
- Whether the pain radiates to other parts of the body,
- How strong the pain is,
- Whether they improve or worsen in certain situations,
- How long they last, since when they have existed,
- Whether there are any other complaints.
Physical examination for back pain
This anamnesis is usually followed by a physical examination. This includes checking the muscular strength of the back and abdominal muscles and the mobility of the back in the various body axes. It should also be checked to see if the patient has localized pressure pain. Differences in leg length are also noticeable in the clinical diagnosis. A neurological examination (the examination of the functioning of the nerves that exit the spinal column) can provide information as to whether the spinal column is damaged and if so, in which area.