Why Is it Difficult to Diagnose What Causes Lower Back Pain?

Many people live with lower back pain, thinking there is nothing that can help them achieve the relief they crave. To compound the problem, there are so many causes of lower back pain, meaning it can be challenging to diagnose, even for trained orthopedists with decades of experience treating back pain. Sometimes the reason is more obvious, such as a traumatic injury accident or spine-related deformity. The most common cause of lower back pain is torn or pulled connective tissues (tendons and/or ligaments). Sprains and strains can happen suddenly, such as lifting heavy objects and twisting the spine, or they can progress slowly over time, for example, from high-impact sports or athletic activities.

Before starting treatment, your orthopedist will perform a physical exam and take your medical history with the goal of diagnosing your condition.

Questions your doctor might ask to determine a diagnosis for your lower back pain include:

  • Is your pain worse at certain times of the day?
  • Has your pain spread?
  • Do you have other symptoms, such as numbness or weakness?
  • What does the pain feel like (dull, stinging, aching, etc.)?
  • Do you have an active or more sedentary lifestyle?
  • What are your sleep habits/postures?
  • Have you had any recent injuries?

How Will My Doctor Diagnose My Lower Back Pain?

After taking a complete medical history, your doctor will perform a thorough physical exam to narrow down the possible causes of your lower back pain. The exam will include palpation along the lower back to locate areas of tenderness or joint abnormalities; a sensory exam to check your reaction to touches, pin pricks, or other senses; and a range of motion test to look for positions that worsen or recreate your pain.

Part of the diagnostic process usually involves ordering several imaging studies so your doctor can check the condition of your bones, intervertebral discs, nerve roots, and connective tissues. This can help diagnose your lower back pain and help your doctor locate a specific problem area. Your doctor will also analyze how you describe your symptoms to get a general idea of the source of your pain. Common imaging tests include X-rays, CT scans, MRI scans. Other diagnostic tests include injection studies.

However, there is no gold standard medical test proven to diagnose back pain. While specific common conditions like a herniated disc or sciatica can be diagnosed quickly and accurately through various clinical tests and medical imaging scans, others are more challenging to pinpoint. The reason why? Pain is a subjective experience that is personal for each individual who experiences it. What may seem like a mild nuisance for one person can be overwhelmingly painful for another. Your own experience with back pain may dictate you need more intensive treatment to handle your pain, such as epidural steroid injections or other interventional back pain treatments.

Should I Seek Medical Attention for Lower Back Pain?

Sometimes, lower back pain can be a symptom of a serious underlying medical problem. You should seek immediate medical attention if you experience any of the following:

  • Loss of bladder or bowel control
  • Recent, unexplainable weight loss
  • Fever or chills
  • Severe abdominal pain
  • Pain after major traumatic injuries
  • If your pain interferes with your daily activities such as mobility or sleep

Contact Us to Learn More About Lower Back Pain Causes & Treatment

Do you have lower back pain? Our board-certified orthopedic physicians at Orthopedic Specialists of Southwest Florida are here to help. Contact us today at (239) 215-2008 to book an appointment and we will be happy to help. We also provide second opinions if you are seeking another medical specialist’s diagnosis for your lower back pain.