Spine is a complex organ. Our spine is made of different elements like vertebrae, disks, ligaments, nerves, spinal cord and vessels. Different problems can happen to any of these elements and cause injury or degenerative changes. Each of these elements when injured or degenerated can cause pain. People have different genetic backgrounds and live in different environments. As a result of these different variables people can develop degenerative changes at different ages.
Pain itself is a complex phenomena. In acute phase, it may correspond with the location of injury or degenerative changes but when it becomes chronic, the location of pain may not directly correspond to the origin of it. So finding the source of pain can be difficult at times and needs patience while the investigations continue.
After taking a thorough history and physical examination we gather enough information to know what investigation needs to be done. Then we have a group of structural and functional tests to find the source of pain. Structural tests show the structure of our spine. These are tests like X-Ray, CT Scan, MRI, etc. In these tests we can find the location of injury or degenerative changes in spine. The functional tests show how the organ works and if the function is impaired or not. Electromyography and Nerve conduction velocity test are among these functional tests that can show us if there is any nerve damage. In some cases, we have to use some diagnostic injections to block specific nerves and find out if they are causing the pain or not. These injections are done under guidance of some sort of imaging like ultrasound or X-Ray to make it as precise as possible. By combining all this information we can locate the source of pain. Locating the source of pain is essential in planning the proper treatment. We will talk about different types of treatment for SPINE PAIN later.