Back pain, although common, is not always caused by musculoskeletal problems. In some cases, the root cause can be neurological problems involving nerves in the spine. Understanding back pain neurology will help you make the right diagnosis, receive proper treatment, or manage your condition long-term. Neurologists can identify nerve-related conditions that cause back pain, which are not always picked up by standard orthopaedic assessments.
This article explains the different types of neurological evaluations, how to use diagnostic tools, and what specialists do when determining whether a patient’s pain is due to muscle or nerve involvement. For more on expert neurological assessments, visit https://www.southvalleyneurology.com.
Back Pain That Is Neurologic In Origin
The cause of back pain may not be as simple as poor posture and muscle strain. Neurological causes can include:
- Herniated disks pressing nerves
- Spinal stenosis (narrowing of the spinal canal)
- Sciatica from nerve root compression
- Peripheral neuropathy
- Myelopathy associated with spinal cord injury
When a back pain patient experiences numbness and tingling down their legs or even a shooting pain, there are likely nerve-related issues rather than only muscular ones.
The Neurological Assessment Process
Back pain neurology typically starts with a complete medical history. Next, targeted diagnostic testing is done. Here’s a neurologist’s approach:
1. Patient History and the Symptom Review
Understanding pain is the key to successful treatment. Neurologists may ask specific questions.
- Is your pain burning, dull, or sharp?
- Does it spread to the legs and arms?
- Does numbness or weakness of the muscles cause symptoms?
- Does the pain get worse at certain times of the day or night?
This can help narrow down any possible spinal nerves or root regions.
2. Neurological Exam
The physical exam will focus on evaluating nervous function through tests such as:
- Reflex test: diminished or exaggerated receptiveness can indicate nerve root compression.
- Muscle Strength Evaluation: Certain patterns suggest spinal nerve involvement.
- Gait observation and balance: Abnormalities may indicate spinal cord, brain, or other involvement.
Diagnostic Tools & Imaging Techniques
Following a neurologist’s suspicion of a possible neurological basis for the pain in the back, these tools are usually used to assess it further:
1. Magnetic Resonance (MRI)
MRI has become the gold standard for examining soft tissues. This includes spinal discs as well as nerve roots and the spinal cord. It can reveal
- Herniated or swollen discs
- Nerve compression
- Spinal cord inflammation or lesions
- Degenerative changes
2. Computed Tomography (CT) Scans
CT scans help assess the bone structures. They can be used as a substitute for MRI or to enhance MRI results.
- Bone spurs
- Fractures
- Spinal canal enlargement
3. Electromyography (EMG)and Nerve Conduction Studies (NCS)
These tests measure electrical activities in muscles and the nervous system to detect anomalies. EMG and NCS assist:
- Confirm radiculopathy (nerve roots issues)
- Distinguishing between nerve and muscular disorders
- How to assess the severity and extent of nerve damage
4. Myelography
Myelography involves injecting contrast dye into the spinal canals before performing CT or X-ray scans. It is especially useful for patients unable to undergo MRI, as it provides detailed images.
5. Ultrasound
While it is not commonly used for deep spinal structures like the vertebrae, ultrasound can help guide the placement of needles in diagnostic blocks or during injections.
Advances In Neurology Techniques For Back Pain
Neurologists will often use functional assessments and diagnostic injections to diagnose complex cases.
- Selected Nerve Root Blocks: These injections administer local anaesthetics to specific nerves to confirm where the pain originates.
- FMRI (functional MRI): Used to study brain activity and pain perception in some cases.
- Qualitative Sensory Testing: A specialized test for measuring how nerves are affected by pressure, temperature, and vibration. It can give insight into sensory nerve damage.
Neurological Back Care: A Collaborative Approach
Neurologists often collaborate with orthopaedic surgeons, pain specialists, and physical therapists to create treatment plans. When a neurologic diagnosis is confirmed, several options are available.
- Nerve rehabilitation – a physical therapy tailored to your needs
- The medications that treat neuropathic or chronic pain include gabapentin and pregabalin.
- Epidural steroid injections
- Surgery in severe or nonresponsive cases
Conclusion
When conventional back pain treatments don’t work, it is essential to look at the neurological side of the problem. Neurologists utilize advanced tools and provide detailed assessments to discover issues that may be invisible through standard examinations. Understanding spine neurology helps you get an accurate diagnosis and effective treatment.
To learn more about neurological approaches to treating back pain, visit https://www.southvalleyneurology.com and consult with experienced professionals who specialize in uncovering the root cause of your discomfort.