A clinical diagnosis concentrates on the root cause of the patient’s back or neck pain,nerve pain and other symptoms. The Four major steps that help a physician make an appropriate diagnosis are :

  • Physical Exam : The physician might perform a physical examination of the patient to test the following:
    • Nerve Functions in certain parts of the arm or the leg : The physician uses a reflex hammer and taps certain areas to check for the patienst reflexes. If there is very little or no reaction felt, it indicates a likely nerve compression in the spine.
    • Muscle Strength : The physician will conduct a neurological exam to assess muscle strength and look out for any twitching, muscle atrophy or any other abnormal movements.
    • Pain with Motion or palpation : Touching certain structures gives the physician an idea of what causes the pain. For eg – Pain over straightening the leg may denote a pinched nerve.
  • Reviewing Patient History : The physician will review the complete history of the patient to rule out other causes or conditions that may be responsible for the pain. This might include past illnesses, treatments and surgeries undergone, medications, etc.
  • Reviewing Symptoms : The physician will review all symptoms including the location of the pain, type of pain experiences ( E.g. : dull, aching, sharp, shooting) and postures, activities, treatments that worsen or lessen the pain.
  • Diagnostic Tests : Post forming an opinion, certain diagnostic tests may be ordered to confirm the disc problem or to gather additional information such as the exact location of the nerve impingement or disc herniation. The diagnostic tests may include :
    • CT scan : Computerised Tomography scan works like an Xrays where in an Xray beam is shot into the body with a computer reformatting the images info Cross sections of the spine.
    • MRI scan : Magnetic Resonance Imaging scans permits doctors to make a accurate assessment of the spinal nerves and anatomy that includes alignment of the discs, height, hydration and configuration of the discs
    • Discogram : If surgery is being considered , some physicians request for a discogram to confirm which disc is most painful. This involves injecting a radiographic dye into the disc and is not used by many doctors except in very rare cases.

An accurate medical diagnosis can be made only when the MRI scan other diagnostic tests are a reflection of the doctors physical exam. Basis this, an effective treatment plan is prescribed to help the patient.


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