- Chiropractor
- Physical therapist
- Neurosurgeon
- Pain medicine specialist
- Physiatrist
- Rheumatologist
- Orthopedic spine surgeon
Chronic Pain Diagnosis

- When did the pain begin?
- Describe and rate the pain, is it shooting, electrical, burning, throbbing, dull, or sharp?

- Has there ever been an injury at or around the problem area?
- What activities/actions/movements relieve and worsen the pain?
- Is there a history of mental illness, like depression or anxiety?

Labs
Tests will be ordered to identify physical/non-physical causes that could be the cause or contributor. Possible tests include:Blood
Blood tests are used in the diagnosis of infections and inflammation. Individuals with infection/s or inflammatory disorders have high levels of white blood cells and inflammatory reactive substances like C-reactive protein. Blood tests also help determine the presence of rheumatoid arthritis, gout, or cancer. If rheumatoid arthritis is present, the blood analysis will show positive results for proteins known as rheumatoid factor.Urine
Urinalysis is commonly used to check for gout. This is a type of arthritis that causes high blood levels of uric acid. A doctor may order a urine test for a patient using prescription pain meds.Spinal tap
A doctor inserts a needle into the lower back and a sample of cerebrospinal fluid is collected. Cerebrospinal fluid is clear and protects the brain and spinal cord. A cerebrospinal fluid analysis helps to diagnose disorders of the central nervous system and certain cancers.
Musculoskeletal/Neurological tests
A musculoskeletal exam looks at posture, joint mobility, muscle stiffness, tightness, and swelling in or around the area, as well as the rest of the body. An example is a diagnosis of carpal tunnel syndrome. A detailed spine examination is done to identify deformities and moving/walking posture. A neurological examination is used to check:- Muscle strength
- Touch reaction
- Balance
- Overall sensation
- Memory
- Alertness
- Mood
- Behavior
Imaging
Imaging provides detailed images of the body’s organs and bones. Doctors use these to:- Spot fractures or inflammatory alterations in the bone/s
- Focus on details of a bone and surrounding structures
- Differentiate between growths, infections, or fractures
- Identify nerve/s injury or damage
X-Rays
X-rays are standard in the diagnosis of fractures. An arthrogram is an x-ray that uses a contrasting agent to check and identify joint disorders.MRI
Magnetic resonance imaging uses a magnetic field and radio waves to create detailed images. Magnetic resonance imaging helps in diagnosing:- Low back pain
- Fibromyalgia
- Osteoarthritis
- Migraine
- Pelvic pain
- Peripheral neuropathy
Electrodiagnostic
EMG – Electromyography
EMG’s are used to diagnose disorders of the muscles and nerves. Electrical activity in the muscles is recorded to see how the impulses/electrical signals are transmitting from the nerves to muscles.
- Numbness
- Muscle weakness
- Muscle pain
- Tics
- ALS – Amyotrophic lateral sclerosis
- Carpal tunnel syndrome
- Radiculopathy from pinched nerves in the spine
- Muscular dystrophy
Nerve Conduction
A nerve conduction study measures the speed of electrical signals passing through a nerve. It can identify:- Carpal tunnel syndrome
- Herniated disk disease
- Sciatic nerve injury/damage/abnormality