Back Pain Diagnosis: Dynamic Radiographic Computerized Analysis

There are enough people out there that have suffered from short term or long term injuries that the following types of tests are common knowledge: X-rays, CT Scans, MRIs, and Ultrasound (sonography). But as more sophisticated technology becomes available, and as our knowledge of the musculoskeletal and nervous system grows, new diagnostic tools are becoming available. One of these sophisticated techniques available is Dynamic Radiographic Computerized Analysis. This tests, like CT Scans and MRIs, produce more detail of soft tissue structures and soft tissue injuries that X-Rays.

The traditional diagnostic tests available are good at detecting obvious injuries, such as torn soft tissues, broken bones, bone fractures, and scoliosis. Where these tests may come up short is for finding more subtle changes to the soft tissues of the spine, such as ligament laxity, more commonly known as loose ligaments. The laxity of ligaments is one of the most common causes of back pain, according to doctors such as Joseph Valdez, MD. Ligaments are the fibrous tissues that connect bones to other bones, including those of the spine and those that are separated by the synovial joints. The result of a loosening of the ligaments may include pain as a result of nerve fibers on the ligaments themselves sending out pain signals, as well as the various types of joint injuries that may occur as a result of the destabilization of the joints. Dynamic radiographic computerized analysis is one type of diagnostic procedure that may be available to determine ligament laxity. This study involves taking a series of X-Ray images, while the patient is placed in various body positions, in order to detect specific abnormalities in the vertebral spine.



With this study, the doctor will direct the patient into different positions, such as extension, flexion, and neutral, marking specific points on the vertebral bodies in the images. Then a program will provide a comprehensive mapping of the vertebral spine and specific levels of the spine where the soft tissue injuries are suspected. The results of this mapping of the spine may help the doctor to determine if the vertebral bodies are in the correct position, or out of alignment. Based on the research available, doctors will know what the normal range movements are at various levels of the spine, when the ligaments are strong and healthy. In areas of the spine that ligaments are stretched, patients may have a greater range of motion. This greater than normal range of motion is called hypermobility. In the opinion of doctors such as Valdez, this hypermobility is evidence of pathology to the ligaments.

Dynamic Radiographic Computerized Analysis may be used at various levels of the spine to determine whether ligament laxity is the cause of neck pain or lower back pain. Some doctors are more receptive to the idea of this being a cause of back pain than others. Doctors point to the strength of ligaments as a reason that our ligaments remain strong and unlikely to deteriorate through the course of our lifetime. But two details support the idea that loose ligaments are the cause of back pain. One piece of evidence is the fact that for many people, back pain actually decreases as we get older. The reason that back pain goes away as we age is because the ligaments and tendons get stiffer and lose flexibility with age. These changes in the ligaments, while reducing our mobility, have the effect of stabilizing the spine. Another piece of evidence comes from studies indicating that prolotherapy, a treatment designed to shorten the length of ligaments, are often successful at treating back pain.