Tests: What Do they Really Show?

Some of the most common diagnostic tests for determining the cause of back pain include the X-Ray, CT Scan, MRI, Sonography, Discogram, and Dynamic Radiographic Computerized Analysis. These tests, individually and collectively, tell us a lot of the bones of the spine and their associated structures, including the muscles and soft tissues that move the spine. These tests are very successful in helping doctors finding the primary pain generator - or the cause of joint pain or back pain. Do these tests provide conclusive evidence of the cause of back pain in all cases. No, in many cases doctors never determine the source of the patient's back problem. In many other cases, doctors will actually be successful at treating a person's back pain without ever actually discovering its cause. How is this possible? This fact becomes possible when you understand that there are several universal fundamentals that contribute to the strength and health of the back, and when these fundamentals are followed, it will help to treat of compensate for a variety of injuries. Here are some of the fundamentals to understand about the spine.
  1. Often the source of back pain is due to instability of the spine. The spine may become unstable due to a variety of degenerative conditions and injury, including facet joint disease, disc disease, and vertebral subluxations.
  2. Treatment protocols that are designed to strengthen the back muscles and abdominal (core) muscles promote stability of the spine, regardless of the cause of the back pain or lower back pain.
  3. Certain lifestyle factors can contribute to causing back pain or treating it. Bad lifestyle habits include obesity, smoking, drinking, poor posture, and poor ergonomics at work. Good lifestyle habits include exercise, staying hydrates, and maintaining a balanced diet. Among the scientific literature, there appears to be little support for the value or herbal supplements and nutritional supplements at reversing the loss of joint cartilage.
  4. Posture and work ergonomics appears to be the number one causes of back pain. Personally, I know that my own back pain feels worse on Monday and better on Saturday. This is due to the fact that On the weekend, I'm sitting on the computer and slouched over - working on this website, while I am on my feet during the week at my job. The research literature often presents the finding that we put more strain on our backs when we are standing vs. when we are sitting.
  5. Diagnostic tests portray a very detailed profile of the joints of the spine, its soft tissues, and pathology.


This brings us back to the ultimate question of "Tests: What do they really show?" We do know that these tests are quite good at showing pathology to the spine, and even when pathological changes to the spine result in compression of the nerves, which give us our ability to feel and move and of course, our ability to feel pain. From certain studies, we also know that pathology occurs in people with back pain as well as people who feel fine, and have never suffered from chronic back pain. How is this possible, when we know that degenerative changes to the spine are the cause of back pain. Because we don't know that. Now we know that many people DON'T have pain as a result of degenerative conditions. The results of these studies tell us that we may use diagnostic tests as a guide towards determining the cause of back pain, but to consider other causes as well.