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Back pain is generally diagnosed through a visit to your primary care doctor. S/he should take a thorough medical history and physical exam which should identify any dangerous conditions or family history associated with your pain. You should be as detailed as possible when discussing your pain including the onset, site and severity; duration of your symptoms; limitations in movement; and a history of previous episodes or health conditions you may think are related. Your doctor may then determine additional tests are necessary such as blood work and imaging tests. A variety of diagnostic methods are available to confirm the cause of back pain:
• X-Ray Imaging includes conventional and enhanced methods that can help diagnose the cause and site of back pain. A conventional x-ray, often the first imaging technique used, looks for broken bones or an injured vertebra. With application of a low-dose ionized radiation beam, a picture is taken that within minutes, clearly shows the bony structure and any vertebral misalignment or fractures. This procedure is fast, non-invasive, and painless but it won't show tissue masses such as injured muscles, ligaments, or bulging discs.
• Discography involves injecting a contract dye into a spinal disc thought to be causing the pain. The dye outlines the damaged areas on the x-rays taken following injection.
• Myelogram enhances diagnostic imaging of an x-ray. The contrast dye is injected into the spinal canal which then allows spinal cord and nerve compression caused by herniated discs or fractures to be seen.
• Computerized Tomography (CT) is quick and painless. This diagnostic tool is used when disc rupture, spinal stenosis or damage to vertebrae is suspected. X-rays are passed through the body at various angles and a computerized scanner then produces two-dimensional slices of internal structures.
• Magnetic Resonance Imaging (MRI) is also a non-invasive procedure used to evaluate the lumbar region for bone degeneration or injury or disease in tissues and nerves, muscles, ligaments, and blood vessels. Unlike the CT, an MRI produces either two-dimensional or three-dimensional images and can differentiate between bone, soft tissues and fluid-filled spaces.
• Electromyography (EMG) assesses the electrical activity in a nerve and can detect if muscle weakness results from injury or a problem with the nerves that control the muscles. Very fine needles are inserted in muscles to measure electrical activity transmitted from the brain or spinal cord to a particular area of the body.
• Bone Scans are used to diagnose and monitor infection, fracture, or disorders in the bone using a small amount of radioactive material. Scanner generated images will then show irregular bone metabolism, abnormal blood flow or measure levels of joint disease.
• Thermography involves the use of infrared sensing devices to measure small temperature changes which can reveal the presence or absence of nerve root compression.
• Ultrasound Imaging uses high-frequency sound waves to obtain images inside the body. This technique can show tears in ligaments, muscles, tendons, and other soft tissue.