History and Physical Exam for Low Back Pain
A thorough history to evaluate low back pain includes an assessment of:
Your doctor or nurse may also give you a written questionnaire to screen for depression or to assess how low back pain is affecting your life, to rate your job satisfaction, and to describe your support system at home and at work.
During the physical exam, your doctor will ask you to do a series of movements while you stand, sit, and lie down. This makes it possible to assess muscular and sensory problems contributing to your low back pain. The physical exam will also include:
The results of these tests will help your doctor see whether your back pain and other symptoms are related to pressure on a nerve and which nerve or nerves may be compressed. Your doctor will use this information to help determine what type of treatment is most likely to be effective.
Why It Is Done
The history and physical exam are the first part of the work-up for low back problems. Your doctor may change or skip some of the tests to avoid further injuring your back.
The history and physical exam for low back pain may provide these results:
History does not reveal an obvious cause of the low back pain.
A physical exam does not cause the same type of pain, muscle weakness, or nerve-related symptoms that you have been having.
Your doctor may recommend:
The medical history and physical exam are likely to distinguish between a low back problem related to a muscle strain or overuse and one that is caused by pressure on a nerve or another more unusual problem.
What To Think About
Pain can be related to both physical and emotional causes. When you're stressed, for example, muscle tightness or spasm can set into your back, causing pain or making it worse. Similarly, troubling emotions can make pain worse. If you or your doctor have a sense that your pain is being caused or made worse by stress, anger, or other difficult emotions, be sure to plan for specialized treatment. Cognitive-behavioral therapy and biofeedback are two types of treatment that can give you tools for managing your pain.
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