Specialists such as orthopedists,
neurologists, neurosurgeons, rheumatologists, internists, anesthesiologists,
and Pain Management Specialists, have an array of diagnostic tests at their
disposal.
X-RAYS
X-rays can show bone deformities or
fractures of the spine. Although the disks themselves cannot be seen,
vertebrae that appear too close together may indicate that the disk has
ruptured or degenerated. Though helpful in diagnosing certain diseases, such as
Ankylosing Spondylitis and osteoporosis, X-rays are more valuable for what they
rule out (for example, cancer or tuberculosis) than for what they reveal.
CAT SCANS (CT)
CAT scans (computerized axial
tomography) are special X-rays used with a computer to produce images of a
"slice" of anatomic tissue. They are good for looking at the spinal
cord, spinal bones, fractures, osteoarthritis damage, narrowed spinal canal
(spinal stenosis), tumors, and spinal cord infections. Like X-rays, they are better
to visualize hard structures, such as bone.
MAGNETIC RESONANCE IMAGING (MRI)
Magnetic resonance imaging (MRI)
uses a strong magnetic field and a computer to create highly detailed images of
soft tissues, such as muscles, cartilage, ligaments, tendons, blood vessels,
and, to a lesser extent, bone. MRI can also show disk degeneration, protrusion,
and rupture; infection; and other spinal disorders.
MYELOGRAMS
A myelogram is another type of
X-ray examination. Before taking X-rays, the radiologist injects a contrast
medium (dye) into the spinal canal. This dye blocks X-rays and outlines the
spinal cord and spinal nerves. Myelograms can show a ruptured disk.
ELECTROMYOGRAMS
An electromyogram (EMG) is a
graphic record of muscle contraction that can show nerve and muscle damage.
IMPORTANT NOTE
It is important to remember that
there are no perfect diagnostic studies. The results of these studies have to
be examined taking into consideration the results of the physical exam, the
symptoms, and the patient's history. Only then, can a sound differential
diagnosis can be considered.
ABOUT THE BACK AND BACK PROBLEMS
The human spine (or backbone) is
made up of small bones called vertebrae, or vertebral bodies. The vertebrae are
stacked on top of each other to form a column. Between the vertebrae are
cushions known as disks. The vertebrae are held together by ligaments. Muscles
are attached to the vertebrae by bands of tissue called tendons.
Openings in each vertebra line up
to form a long hollow canal. The spinal cord runs through this canal from the
base of the brain. Nerves from the spinal cord branch out and leave the spine
through the spaces between the vertebral bodies.
The lower part of the back holds
most of the body's weight. Even a minor problem with the bones, muscles,
ligaments, or tendons in this area can cause pain when a person stands, bends,
or moves around. Less often, a problem with a disk can pinch or irritate a
nerve from the spinal cord, causing pain called sciatica that runs down the
leg, below the knee.