In the vast majority of cases, a combination of activity and medication to ease the pain and unlock muscular spasm will be all you need to heal your back pain. But if the pain does not go away, or if it keeps recurring, your doctor may refer you to a specialist for further investigation.
Consulting Your Family Doctor
When you first consult your family doctor about your back pain, he or she will probably spend a few minutes asking you about your specific symptoms as well your general state of health.
The doctor will then examine you and reach a preliminary diagnosis. If the doctor rules out the likelihood of any serious illness or structural problem he or she will probably advise you to keep active and may prescribe one or more of the following types of drugs: painkillers, anti-inflammatory drugs and/or muscle relaxants and, possibly, antidepressants.
If this treatment does not succeed in giving your back the opportunity to heal itself, it will be necessary to undergo further investigation.
Consulting a Specialist
The specialist’s role is to find out whether your pain is a symptom of a physical disease or condition in your back or elsewhere in the body and, if not, to discover exactly what is causing it. The specialist, usually an orthopaedic surgeon, a rheumatologist or a neurologist, will spend some time taking a careful history of your symptoms and your general health. He or she will then give you a thorough physical examination, looking at your posture and investigating how much movement your spine can make and how well it makes these movements. He or she will probably also manipulate your arms, legs and neck to check for signs of nerve root obstruction.
X-rays are rarely helpful in diagnosing the cause of back pain as the muscles, ligaments and discs do not show up at all or show only very faintly. As result, a condition such as a prolapsed disc could easily be missed by an X-ray. The only clue might be a slight narrowing of the space between two vertebrae but this can be hard to spot and does not necessarily indicate a prolapse. Because of this and because X-rays are known to carry some risks for health, far fewer are taken now than used to be the case.
The specialist will probably also take a blood sample which will be tested to rule out bone disease and other illnesses and conditions that can cause back pain. Depending on the results of the physical examination, X-rays and blood tests, the specialist will be able to make a diagnosis and recommend treatment.
If the specialist finds that the diagnosis is still unclear, further tests may be necessary. In the vast majority of cases, however, they are unnecessary and are normally only carried out if the specialist thinks that surgery might be needed. Always discuss with your specialist the reasons for any tests he recommends and make sure that you are happy it is necessary.