Low back pain history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Diagnosing the underlying cause of low back pain is usually done by a medical doctor, osteopathic physican, physiotherapist (physical therapist) or by a chiropractor. A thorough medical history and physical exam can usually identify any dangerous conditions or family history that may be associated with the pain. The patient describes the onset, site, and severity of the pain; duration of symptoms and any limitations in movement; and history of previous episodes or any health conditions that might be related to the pain. The physician will examine the back and conduct neurologic tests to determine the cause of pain and appropriate treatment. Blood tests may also be ordered. Imaging tests may be necessary to diagnose tumors or other possible sources of the pain.

History

Questions like severity and frequency of back pain will be ascertained. Cause of the pain is important to determine treatment that will be effective like simple measures such as ice, mild painkillers, physical therapy, or proper exercises. Most of the time, back pain will get better using these approaches.

Questions will include:

• Is the pain on one side only or both sides?
• What does the pain feel like? Is it dull, sharp, throbbing, or burning?
• Is this the first time patient has had back pain?
• When did the pain begin? Did it start suddenly?
• Was there a particular injury or accident?
• What was the patient doing just before the pain began i.e. lifting, bending, sitting at computer or driving a long distance?
• Is the present episode of pain similar or different to the last one (if recurrent)? In what way is it different?
• Does the patient know the cause of previous episodes of back pain?
• How long does each episode of back pain usually last?
• Do the patient feel the pain anywhere other than back, like hip, thigh, leg or feet?
• Do the patient have any numbness or tingling? Any weakness or loss of function in leg or elsewhere?
• What makes the pain worse? Lifting, twisting, standing, or sitting for long periods of time?
• What makes the patient feel better?
• Are there any other symptoms present? Weight loss? Fever? Change in urination? Change in bowel habits?