Exams and Tests to Diagnose Chronic Pain

Reviewed by Steven Richeimer, MD

Diagnosing chronic pain can be a long process. As you can learn in the article Causes of Chronic Pain, there are many possible causes, so the doctor will run various exams and tests to try to figure out your pain.

Here are some of the ways the doctor may try to diagnose your chronic pain.

History
Your doctor will take your detailed health history. You'll go over illnesses, any injuries, and medical problems that run in your family. Because chronic pain can develop following illness or injury, it's important to be thorough so the doctor can look at the full range of causes.

You'll also have to be very specific about your pain: description, intensity, frequency, duration, activities that make it worse, if it's better at a certain time of day, etc. If you don't already do this, it might be a good idea to start a pain diary where you record details of your pain. Then you'll be better able to share information with your doctor.

Physical, Neurological, and Mental Health Exams
For the physical exam, the doctor will observe your range of motion (that's how well and how far you can move certain joints), posture, and general physical condition. He or she will make note of any movements that cause or increase your pain.

The neurological exam will test your nerves, so this exam is particularly crucial in chronic pain. The doctor will test your reflexes, muscle strength, and how well you can feel. For example, the doctor might test if you can feel a very light touch on your skin. If you can't, that may indicate nerve damage. The doctor will also see if your pain is spreading to other parts of your body during the neurological exam—did you come in complaining of back pain but find that sometimes, you have pain in your leg, too?

Because chronic pain often has an emotional or psychological component, you may need to have a mental health exam. This is to check for symptoms of disorders, such as anxiety or depression, that can develop alongside chronic pain. The mental health exam will also give your doctor a more complete picture of your overall health.

Diagnostic Tests
To see if there's an injury or identifiable condition causing your chronic pain, the doctor will need to run diagnostic tests. For the imaging tests (x-rays, MRIs), you may have to go to an imaging center to have these done; the results will be sent back to your doctor, who will interpret them for you.

Some possible diagnostic tests are:

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What is Chronic Pain?