Medical history

• Reasoning from the fact that many various conditions may provoke back pain, a methodical medical history will be performed as part of the examination. A number of the questions you are asked may not seem relevant to you but are very essential to your doctor in determining the cause of your pain.

• First of all your doctor will ask you many questions concerning the start of the pain, for example: Were you lifting a heavy object and felt an instant pain? Did the pain come on gradually? Certainly he will want to know what makes the pain better or worse. Your doctor will ask you many questions referring to the “red flag” symptoms. He will probably ask if you have had the pain before. You will also be asked about latest illnesses and related symptoms such as coughs, fevers, urinary difficulties or stomach illnesses. In females, the doctor will want to know about vaginal bleeding, cramping or discharge. Pain from the pelvis, in these cases, is regularly felt in the back.

Physical examination

• To start detailed examination, you will be asked to dress a gown. The doctor will seek for signs of nerve damage at the same time as you walk on your heels, toes and soles of the feet. Reflexes are usually tested with a help of a reflex hammer. This is generally done at the knee and behind the ankle. When you lie flat on your back, one leg at a time is elevated, both with and without the assistance of the doctor. This is accomplished to test the nerves, muscle strength and evaluate the presence of tension on the sciatic nerve. Sensation is usually tested using a pin, paper clip, broken tongue depressor or other sharp object to assess any loss of sensation in your legs.

• Starting from the determination of your doctor what is wrong with you, he may decide on performing an abdominal, pelvic or a rectal examination. These examinations search for diseases that can provoke pain referred to your back. Actually the lowest nerves in your spinal cord call for the sensory area and muscles of the rectum. Thus damage to these nerves can result in failure the ability to control urination and defecation. Accordingly, a rectal examination is essential to make certain that you do not have nerve damage in this area of your body.