Diagnostic Procedures for Pain in the Back at KBNI

During your first appointment at the Kraus Back and Neck Institute you will assist Dr. Kraus with the development of your case history by detailing the onset, duration and intensity of the pain in your back. You will be asked if you have undergone treatments for pain in the back during the previous two years and their outcomes. If you have had previous pain in the back treatment you will be asked to bring the following information (the office personnel can assist you in obtaining this information):

• X-rays and reports
• CT scans and reports
• Myelograms and reports
• MRI scans and reports
• EMG/NCV reports
• Bone scans
• Operative reports

Dr. Kraus will examine your back for flexibility and range of motion. He will also evaluate the strength of your muscles and check your reflexes. In the course of this examination he will be looking for certain signs that suggest that a particular nerve root is being affected. He will ask you about the nature of the pain (shooting, stabbing, burning, etc.) and what makes it better or worse.

When the pain is determined to be non-specific or ambiguous, tests of nerve and muscle electricity – called nerve conduction studies &ndash may be used to localize the impairment. These electrical tests produce a myelogram, which is used to detect impairments in the back that suggest radiculopathy.

Dr. Kraus may also determine that a magnetic resonance image (MRI) is required to evaluate the soft tissue of the spine. It is important that you inform the doctor if you have:

• Artificial heart valves
• Metal pins, screws, plates, stents or surgical staples
• Implanted electronic device, including a cardiac pacemaker
• Implanted drug infusion ports
• Implanted nerve stimulators
• Metallic joint prostheses or artificial limbs

You should also inform the doctor if you are claustrophobic. Other imaging technologies such as x-ray, computed tomography (CAT or CT scan), or ultrasound may also be used to confirm the diagnosis.

Once the source of your pain in the back has been determined, treatment can begin.