Exams and Tests Center
If you have a back or neck condition, your doctor may order different tests to see what’s not visible to the naked eye. How does your doctor know which test or tests to order? By talking with you about your medical and health history, back and/or neck pain and symptoms, and performing a thorough physical and neurological examination.
Step 1: Medical and Health History
The first step is your complete medical and health history. The detailed information you honestly provide helps your doctor to understand your symptoms and spine problem.
Step 2: Physical and Exam
During your physical exam, your doctor thoroughly examines your spine paying particular attention to painful areas and those that are tender. Your range of motion, whether it is your neck or low back, is examined while you move that area of your spine. For example, your range of motion in your low back may be observed while you bend forward, backward, and side-to-side.
Step 3: Neurological Exam
The purpose of a neurological exam is to evaluate your pain/symptoms as they relate to your nervous system. For example, certain reflex response tests may indicate extremity weakness that may correlate with your symptoms.
There are many different types of diagnostic tests. Some of them area explained below. Others are listed in the left-hand column of this page.
- X-Ray: X-rays provide your doctor a snapshot of your spine from different directions, including: front to back, back to front, while you bend forward or backward, or from the side while you stand up straight. However, X-rays are not very effective at showing soft tissue (eg, discs, nerves).
- MRI (Magnetic Resonance Imaging): MRI utilizes magnet and computer technologies to generate detailed images or slices of your spinal anatomy. MRI reveals the structure of soft tissues, such as the discs, spinal cord, and nerves.
- CT Scan (Computed Tomography): CT scans produce slice-like images of the spine. This test differs from MRI in that it utilizes radiation to produce detailed imaging.
- Myelogram: Myelography may be ordered if spinal cord compression is suspected. A special contrast dye is injected into the spine’s dural sac (a protective membrane covering the spinal cord). After injection it mixes with the spinal fluid and circulates through the spine. Next, a series of CT scans or MRIs are taken, which provides the doctor with detailed images of the spine’s cord and nerve structures.
- Bone Scan: Your doctor may order a bone scan for different reasons, such as to learn more about a spinal fracture or tumor. The first step is an intravenous (IV) injection of a radioactive chemical called a tracer. After a period of time, a special camera takes pictures of the skeleton to pinpoint bone changes.
- Electrodiagnostic Studies: An EMG (electromyography) and NCV (nerve conduction velocity) tests are electrodiagnostic tests usually performed together. An EMG study tests muscle function and a NCV studies nerve function.
Your doctor may order certain blood tests too. Different types of inflammatory disorders affect the spine such as ankylosing spondylitis or sacroilitis (lower back and pelvis). Blood tests are also used to detect infections, such as discitis, an infection is one or more intervertebral discs.