Diagnosing the Cause of Low-Back Pain

Because there is a variety of lumbar spine conditions that can cause low-back pain and each can be associated with similar symptoms, an accurate lumbar pain diagnosis requires significant skill and expertise from a spine specialist.

How is Lumbar Pain Diagnosed?

Physicians will perform a series of examinations in order to properly diagnose low-back pain and its causes. These will include a thorough history, physical and medical exam, during which a trained spine specialist will check for signs of acute low-back pain, muscle weakness, tenderness or numbness in the area of the lumbar spine that is affected. Additional lumbar imaging or injection studies may be ordered to arrive at a precise lumbar pain diagnosis.

Lumbar Pain Diagnosis

Diagnosing pain in the low-back requires skilled spinal expertise and a physician who has considerable experience in recognizing and treating lumbar spine conditions. There is a wide range of conditions that can cause pain in the lumbar spine. Diagnosis based on a thorough analysis of symptoms and examinations is crucial to helping patients find the treatment plan that is right for their specific concerns.  Often, this requires “ruling out” certain spine conditions in order to narrow the list of potential causes of a person’s low-back pain. When it comes to accurate lumbar pain diagnosis, the team at BASIC investigates using every appropriate modality available until we have determined the cause of the pain.

The History and Physical

In order to arrive at a specific lumbar pain diagnosis, the most experienced spine experts will first conduct a complete history and physical examination. During the history portion of this evaluation, the patient is asked a series of questions regarding his or her low-back pain symptoms which often include when the pain began, whether there was an injury to the low-back or other part of the spine that caused the pain, a precise explanation of where the pain is located and how intense it is, whether the pain radiates to the lower extremities or other parts of the body, any previous spine surgery and family history of conditions affecting the lumbar spine.

Upon completion of this discussion, the physician will then perform a physical examination aimed at pinpointing an accurate lumbar pain diagnosis. The physical exam helps the doctor rule out certain causes of low-back pain, while honing in on others in order to properly diagnose the pain source. While the low-back will be a feature of the physical exam, other parts of the body may also be examined depending on the low-back pain symptoms that are being experienced by the patient.  Some of the characteristics the physician is evaluating include muscle weakness, pain that radiates into lower extremities, pain or tenderness in certain areas, sensory changes, reflex changes, motor skills and other special signs.


After a thorough physical and history have been conducted in order to learn more about a patient’s low-back pain symptoms, the likely next step in lumbar pain diagnosis is through an imaging study. These types of tests are usually ordered once your physician has a suspicion as to what is causing the low-back pain, based on the history questions and physical exam. Often, the MRI (Magnetic Resonance Imaging) is a preferred lumbar pain imaging exam because its detailed images can show any changes to the soft tissues surrounding the vertebrae in a way that x-rays, historical pain discussions and external physical exams simply can’t. For this reason, MRIs are frequently used to visualize whether there is damage to a lumbar disc, lumbar spinal stenosis, nerve problems or spinal tumors, among others.

Lumbar Epidural Steroid Injection

During a lumbar epidural steroid injection, a local anesthetic medication is injected into the lumbar joint suspected to be causing the patient’s low-back pain. If the injection causes the pain to diminish, then the diagnosing physician can be relatively sure that the lumbar spine joint in question is the cause of the low-back pain and a confirmed lumbar pain diagnosis can then be made.

Accurately pin-pointing the root cause of low-back pain is crucial to a precise lumbar pain diagnosis and perhaps most importantly, an effective treatment plan. While this diagnosis may require multiple steps in order to determine exactly what’s causing the low-back pain, it is important to seek help from a spine expert who is skilled and experienced in effectively diagnosing lumbar pain and then expertly treating it using the least invasive methods first.

Health Tips For Low Back

  • Exercise daily – it helps reduce inflammation & muscle tension
  • Maintain a healthy body weight – extra pounds can make back pain worse
  • Quit smoking – it seriously restricts nutrient rich blood flow to the spinal discs
  • Sleep right – sleeping on your stomach can be hard on your lower back

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