4 Factors That Can Make Low Back Pain Difficult to Diagnose

Pain DiagnosisBack pain, in its many forms and stages, is one of the country’s most common chronic conditions. A PMC report, The Rising Prevalence of Chronic Low Back Pain, indicates that, at some point in our lives, over 80 percent of the entire population will endure at least one episode of low back pain (LBP). More specifically, at any given time, approximately 31 million Americans are experiencing low back pain, ultimately disrupting our work schedules, enjoyment of daily activities, and overall quality of life.

For most LBP patients, the clinical progression is generally benign, with as many as 95 percent of all those afflicted recovering from the pain and discomfort within the first few weeks or months. However, for some people, what initially appears to be an isolated LBP event eventually progresses into a chronic condition that lasts for three months or longer, requiring elevated medical attention and treatment.

Key Components That May Impact Your Diagnosis

Despite the prevalence and rising surge in low back pain episodes, the condition is often fairly challenging to diagnose. Some of the many factors that can convolute the diagnosis process may include:

Difficulty Identifying Pain Source

The anatomy of the back alone can make diagnosis complicated. The lower back is comprised of a multitude of biological components which may contribute to pain acuities and overall spinal health, including:

  • Vertebrae (medically referred to as L1-L5)
  • Intervertebral discs
  • Ligaments
  • Tendons

Additionally, there are thirty-one pairs of nerves located in the spinal cord, helping to control movements as we transmit signals from various body regions to the spine before passing it on to the brain. The structurally complex, highly integrated nature of the lower back can sometimes make it difficult for patients to definitively pinpoint and/or articulate the precise pain region during a physician consultation.

Pain Subjectivity

The subjective nature of pain can also make proper diagnoses of chronic LBP difficult. Everyone has a unique, very personal reaction to and experience with pain. We all have our own particular thresholds, processing and translating stimulus in a way that can be completely different from anyone else.

What one patient distinguishes as mild discomfort another may discern as a severe and debilitating ache based on a multitude of genetic, physiological, and emotional contributors. Additionally, not only do patients have a unique pain experience but they often also have a distinctive pain language, choosing specific words to describe their condition to physicians.

This individualized translation of sensory stimulation complicates both the assessment and treatment of LBP. Pain clinicians must carefully navigate through the task of qualifying and quantifying each patient’s subjective pain experience. While there are a number of available questionnaires and scales available, they are often not sufficient to adequately pinpoint condition intensity.

Testing Challenges

The diagnostic testing process itself can also pose several potential challenges when determining a lower back pain prognosis. One of the biggest obstacles patients may encounter during the evaluation process? There is no single designated test used to effectively assess every patient suffering from chronic back pain, making it critical to partner with a practice capable of running a thorough assessment that includes a diverse range of evaluation tests, tools, and resources.

An experienced chronic pain specialist will begin the process with a consultation and physical examination to discuss your pain levels and observe posture, physical conditioning, and note any specific moves that cause discomfort. From there, you may be required to undergo additional imaging tests to accurately pinpoint the ailment or misalignment, such as:

  • X-rays
  • CT scan
  • MRIs
  • Bone scan
  • Discogram
  • Myelogram

Your physician will carefully develop a specific battery of exams and texts to narrow down the precise cause of your chronic pain and formulate an accurate diagnosis.

Calibrating The Treatment Approach

It’s important to understand that properly identifying the fundamental issue with your back does not always mandate one specific treatment approach. Much like the testing process for chronic back pain, there are also a myriad of recognized practices and therapies available to manage an LBP condition, and every patient has an individualized response to care techniques.

For example, for some patients with acute and lingering discomfort, injection-based treatments such as nerve blocks and epidural steroid injections may provide the most relief. However, other patients with a similar diagnosis may discover that the injections have little to no effect on their condition, finding instead that neurostimulation therapy, such as Spinal Cord Stimulation (SPC) or dorsal root ganglion (DRG) stimulation, have the biggest impact on their chronic episode.

As a result of every individual’s unique treatment needs and profiles, most patients undergo an initial trial and error healing strategy where their practitioner strategically refines and modulates treatment techniques throughout the care continuum to optimize a positive patient outcome.

Patient participation plays a critical role in the ultimate success of treatment recalibration. Throughout the process, it’s vital for you to work collaboratively with your clinician, offering clear and honest insight about the pain intensity levels, any changes in presenting symptoms, and perceived effectiveness of different treatments, practices, and therapies.

We Specialize in Low Back Pain Diagnosis And Treatment

Florida Pain Relief Centers’ expert pain management physicians are fully trained and experienced in the proper diagnosis of low back pain for patients across the LBP threshold.

Our renowned team of interventional pain physicians utilizes a comprehensive approach of innovative testing options and compassionate treatment strategies to optimize patient results.

To consult with our pain specialists, call Florida Pain Relief Centers at 800.215.0029 or click the button below to schedule your visit online.

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