When you first see your doctor, you will be asked questions about your back
pain, including how it started, how often it occurs, how severe it is, and
what makes it better or worse. Your doctor will try to determine the cause
of your back pain and whether it is likely to quickly get better with simple
measures such as ice, mild painkillers, physical therapy, and proper exercises.
Most of the time, back pain will get better using these approaches.
During the exam, your doctor will try to pinpoint the location of the pain
and figure out how it affects your movement. You will be asked to:
- Sit, stand, and walk. While walking, your doctor may ask you to try walking
on your toes and then your heels.
- Bend forward, backward, and sideways.
- Lift your legs straight up while lying down. If the pain is worse when
you do this, you may have sciatica, especially
if you also feel pain, numbness, or tingling in one of your legs.
Your doctor will also move your legs in different positions, including bending
and straightening your knees. All the while, the doctor is assessing your strength
as well as your ability to move.
To test nerve function, the doctor will use a rubber hammer to check your
reflexes. Touching your legs in many locations with a pin, cotton swab, or
feather tests your sensory nervous system (how well you feel). Your doctor
will instruct you to speak up if there are areas where the sensation from the
pin, cotton, or feather is duller.
Most people with back pain recover within 4 - 6 weeks. Therefore, your doctor
will probably not order any tests during the first visit. However, if you have
any of the symptoms or circumstances below, your doctor may order imaging tests
even at this initial exam:
- Pain that has lasted longer than one month
- Muscle weakness
- Accident or injury
- If you are over 65
- You have had cancer or have a strong family history of cancer
- Weight loss
In these cases, the doctor is looking for a tumor, infection, fracture, or
serious nerve disorder. The symptoms above are clues that one of these conditions
may be present.
If you are following your doctor's initial instructions and do not improve
after 1 - 3 weeks, you should call for a followup appointment. Your doctor
will determine if you need to see a physical therapist and
can refer you to one in your area.
If your pain lasts longer than one month, your primary care doctor may order
imaging tests and send you to see either an orthopedist (bone specialist) or
neurologist (nerve specialist).
Review Date: 4/6/2007
Reviewed By: Benjamin D. Roye, M.D., M.P.H., Orthopaedic Surgery, The Mount Sinai Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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