Diagnosing and Medicating Back Pain

You have been experiencing back pain for more than 72 hours, you have taken over the counter medications, tried hot and cold packs, resting with your feet up and hot baths, but the pain is still there.  You have a doctor’s appointment and are wondering what tests may be scheduled by your doctor and what they are.

Diagnostic tests usually aren’t necessary for determining the chief cause of your back pain.  When you are visiting your doctor regarding back pain, your medical professional will want to examine you first.  The doctor will evaluate your ability to stand, sit, walk, and lift your legs. These assessments will help your doctor figure out where the pain is coming from, how severe it is, if the movement causes muscle spasms, ruling out serious conditions which could be affecting your back.

If your doctor suspects a serious condition which may be causing your back pain your doctor will order one or more tests.

Diagnostic Tests for Back Pain:

  • X-ray– The images will show your doctor is there are any misalignments of your bones, arthritis or broken bones.  X-rays don’t show problems of the spinal cord, muscles, nerves or disks.
  • Magnetic resonance imaging (MRI) or computerized tomography (CT) scans– These scans can produce images of the spine after dye has been injected into the spinal column. The scans may reveal herniated disks or problems with the bones, muscles, tendons, tissue, nerves, ligaments and blood vessels.
  • Bone scan– Sometimes your doctor may order a bone scan, to look for bone tumors or compression fractures caused by Osteoporosis.
  • Nerve studies– This test measures the electrical impulses produced by the nerves and the responses of the muscles.  This test can confirm nerve compression caused by a herniated disks or a narrowing of the spinal canal.


Your doctor also may order some blood tests and urine tests, to rule out kidney disease and infections.  You may be required to come back several times before your doctor can rule out or confirm the causes and diagnosis of your condition.  Treatment options may include medications, physiotherapy, exercise, weight control, and orthopedic bracing.




Medications to Treat Back Pain:


  • Your doctor may recommend pain relievers such as acetaminophen, non-steroidal anti-inflammatories which include ibuprofen or naproxen.  Your doctor may also include a muscle relaxer.  Muscle relaxers can cause drowsiness, so don’t drive while on this medication.
  • Narcotics may be used to relieve the pain, for short periods of time.  These include codeine or hydrocodone.
  • If you are stressed (which can contribute to the back pain), there are certain types of anti-depressants which have been shown to relieve back pain.  The most common ones are tricyclic antidepressants such as amitriptyline.
  • If rheumatoid arthritis is suspected you may need anti-rheumatic drugs (DMARDs)


If the medication has little or no affect on the pain, you may need further evaluation and may be required to begin other treatments such as physical therapy which could include hydrotherapy, physiotherapy and occupational therapy.  Surgery is usually recommended when other treatments are proven to be ineffective due to severe damage to your back.


More often medications and rest can relieve the symptoms of back pain within a few days.  Your doctor will ask you to return for a follow up appointment to see if the medication is working and if further treatment is required.  Keeping your appointment is the best way to get relief and back into your life.

Barbara Lucore

I have been a nurse for 15+ years and as a nurse I understand how to prevent back strain and pain. The correct ways to lift objects, the causes of back pain, treatments available, the exercises to reduce or prevent back pain and the proper ways to move without strain or injury to your back.