The first step is to take a detailed history and perform a clinical examination. Our team assesses if there is a specific pain generating structure, or if the pain is referred pain (i.e. due to nerve compression in the spine, or a pain generator higher up along the kinetic chain referring down the arm or leg).
Next, we assess special investigations like MRI scans. Usually MRI and other types of scans are not very helpful in finding the cause of chronic pain. In general MRI’s are helpful to rule out sinister pathology e.g. tumors, look for nerve compression that can explain nerve referred pain and to look for specific disc changes that have been linked to chronic back pain.
To make an accurate pain diagnosis we use various diagnostic interventions. In general, the main aim of diagnostic interventions is to numb a potential pain generator for a short period of time, allowing you to test the response. If that structure is your main pain generator then you should experience at least a short-term significant reduction in pain, and you should be able to perform a pre-intervention painful action with minimal or significantly less pain. Sometimes we are unable to identify a specific pain generator. In those cases, pain may be generated from local nerve or more central nerve hypersensitivity mechanisms.