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- Examination: Diagnosing the underlying cause of neck and back pain can be difficult. A medical history that includes age, weight, current and past medical problems, medications, and height is taken. Also, a complete physical examination, which may include a neurological exam, is performed.
- X-ray: X-rays show the alignment of the spine and may reveal degenerative joint diseases, fractures, or tumors.
- Magnetic resonance imaging: Magnetic resonance imaging (MRI) scans provide clear images of disc deterioration, pathologies of the spinal cord, spinal stenosis, herniated discs, spinal tumors, and abnormalities in nerves and ligaments. MRIs are conducted in a small, confined areas and some individuals may find this uncomfortable. Some individuals may have to be sedated using a mild sedative such as alprazolam (Xanax ®) or lorazepam (Ativan ®). If the individual is sedated, transportation should be organized with a family member or friend to take and return home the individual, due to drowsiness and decreased coordination.
- Computerized tomography: Computerized tomography (CT) scan is an X-ray that uses computer technology and can be enhanced with the injection of a contrast dye. CT scans are used to show abnormalities in bones and soft tissue. CT scans can be used for individuals who are unable to tolerate MRIs.
- Myelography: Myelography is used to examine the spinal canal and cord. Contrast dye is injected into the cerebrospinal fluid in the spine. This allows the doctor to outline the spinal cord and nerve roots, and abnormal disc conditions or bone spurs can then be visualized using an X-ray or CT scan.
- Electromyogram: Electromyogram, or
EMG, is the use of tiny electrodes inserted into muscle tissue to test for abnormal electrical signals. Abnormal electrical signals may indicate that a nerve root is pinched or irritated at the spine. An anesthetic, such as lidocaine or Xylocaine ®, is used to reduce the pain of electrode insertion into the skin.
- Spinal tap: Spinal tap involves drawing a sample of cerebrospinal fluid and analyzing it for elevated pressure, infection, bleeding, or tumor. Spinal tap may be painful and may require sedation.
- Radioactive bone scan: Radioactive bone scans locate problems (such as a fracture or osteoporosis) in the vertebrae. A chemical called a radioactive tracer is injected into the patient and after several hours, a gamma camera picture will reveal bone undergoing rapid changes where large amounts of tracer accumulate.
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