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What diagnostic tests can diagnose chronic back pain ?

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I need to advocate for myself better with my Primary Care doctor and have an appt next week. Are there another diagnostic tests that I can ask for to determine my problem? I would deeply appreciate any advice. Thank You.

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replied August 20th, 2007
Muscular and Nerve Disorders Answer A3218
You wrote:

"Current medical status: I have chronic back pain. The bottom right side of my back must have got injured somehow (???) during or right after my pregnancy b/c I began having terrible pain there, esp. At night. It has now been two and a half years & the pain has only gotten worse. I went to lots of doctors & specialists, got an MRI, went to a chiropractor for months, went to physical therapy, got massage therapy, cortisone shots, took suggested supplements, bought a tread mill and walked, did home exercises to strengthen my core, tried to lift correctly and stopped picking up my little girl so much, but still I am in awful pain. Also, I am not overweight, eat a healthy diet, and only wear good tennis shoes everyday for my back. Over the years the doctors' have told me that I do not have any spinal problems and the problem is muscular. My last MRI was 1 1/2 ago. So, right now I just try to cope with the pain. I take tramadol daily and vicodin. I also take the maximum recommended doses of tylenol and ibuprofen daily. I don't want to take any more drugs, esp. more addictive ones. The worst part of it all is that I am getting very little sleep and it's affecting my daytime functioning. I get up several times a nite when my back "seizes" and spasms and do my muscle rub, back stretching, heaing pad routine until I can fall asleep again. I have recently ordered an expensive TENS unit online b/c I heard it can help. Overall, I'm desperate at this point since nothing else has worked.

Current medical treatment: Home treatment: Ultram ER 300 mg, Vicodin 1 pill 2x day, Soma 750 mg 1xday, Tylenol 2000 mg day, ibuprofen 2400 mg a day, Tiger Balm muscle rub several times a day No current treatment as I have tried the above mentioned treatments and did not respond."

The back muscles help the body keep balance.You and your doctor should first distinguish if the pain is neural or muscular. Neural pain usually occurs when something causes pressure on spinal nerves. Disk hernias and osteophytes usually create pressure on the roots of the spinal nerve and cause neural pain in the back or extremities depending upon the location. Muscular pain is usually due to muscle spasms. Muscle spasms can be due to injury, overworking, etc. If there a static spine disorder is present (scoliosis, lordosis or kifosis), the back muscles become overactive and painful. Static spine disorders can be identified with an X-ray image.
You can consult an orthopedist for advice, diagnosis, and treatment options.

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