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| Back Pain Test | Nerve Tests
• Electromyogram or EMG is a test that involves the inserting of very small needles into the muscles. Electrical activity is monitored and its use is regularly reserved for more chronic pain and to calculate the level of nerve root damage. In addition the test is able to help the doctor make a distinction between nerve root disease and muscle disease.
Imaging
• Doctors can use several tests to "look inside you" to get an idea of what might be causing the back pain. Any particular test is perfect in that it identifies the absence or presence of disease 100% of the time.
• The medical literature is very plain: if there are no red flags, there is little to be gained in imaging acute back pain. Since about 90% of people have improved within 30 days of the onset of their back pain, most doctors will not order tests in the routine evaluation of acute, uncomplicated back pain.
• Basic x-rays are generally not considered useful in the estimation of back pain, particularly in the first 30 days. In the absence of red flags, their use is discouraged. Their use is pointed out if there is significant trauma, mild trauma in those older than 50, people with osteoporosis and those with expanded steroid use. Do not wait for an x-ray to be taken.
• Myelogram is an x-ray study in which a radio-opaque dye is injected straight into the spinal canal. Its use has decreased dramatically while MRI scanning. This test is now frequently done in combination with a CT scan and, even then, only in special situations when surgery is being planned.
• Magnetic resonance imaging (MRI) scans are a highly complicated test and accordingly are very expensive. The test does not use x-rays instead it is making use of very strong magnets to produce images. Their routine use is hinder acute back pain unless a condition is present that may call for urgent surgery, such as with cauda equina syndrome or when red flags are present and suggest infection of the spinal canal, bone infection, tumor or fracture.
o MRI may also be considered after 1 month of symptoms to discount more serious underlying problems.
o MRIs are not without problems. Bulging of the discs is noted on up to 40% of MRIs performed on people without back pain. Another study has shown that MRIs fail to diagnose up to 20% of ruptured discs that are found during surgery.
• CT scan is an x-ray test that is able to create a cross-sectional picture of the body; it is used much like MRI.
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