Back Pain

28. August 2018

An accurate diagnosis is important.

Details about a diagnosis for back pain

The diagnosis for back pain involves a combination of questioning, medical history and describing the pain. The patient must become actively involved and answer the doctor’s questions as accurately as possible, because, unlike with other illnesses, he or she does not have a variety of diagnostic devices for making unequivocal statements.

With the diagnosis of back pain, the aim is to analyse the causes of back pain, classify the seriousness of the back pain and find the factors, which would favour the development of chronic back pain, for example.

At the beginning, the aim of the medical history is to record the manifestations of the pain. Common questions go in the direction of

  • Localisation of the back pain;
  • Radiation of the back pain (sideways, above or below the knee);
  • Duration of the current back pain;
  • Previous complaints and treatments;
  • Factors, which act as a trigger or favour the development of back pain;
  • Strength of the pain during various activities, accompanying illnesses or complaints;
  • additional aspects, such as those of a psychosocial nature (stress, stressful situations, etc.).

For a treatment to also be understood by all doctors, physiotherapists and others involved, doctors rely on a standardised pain questionnaire for the diagnosis of back pain.

What does the flag model mean?

Over the years, a flag model has established itself, which is intended to assist with better planning the treatment and taking relevant diagnostic aspects into consideration. For affected persons, it is meaningful to classify the illness, as this way, back pain is related to accompanying symptoms or pre-existing conditions, which assist in recognising the specific causes more quickly. Specific back pain always has a pathological character, but in any case, it needs to be treated by a doctor.

Red flags accordingly go in this direction, while yellow flags focus on psychosocial factors, which pose a significant risk. The risk should specifically not be disregarded, because the risk exists that acute back pain may transform into chronic back pain. In the meantime, many studies indicate that conflicts that exist at the workplace, depressions or stressful disputes in the private environment, pose a considerable risk.

Naturally, with the diagnosis of back pain, it also involves mechanical influences, such as excessive strains due to work. These accelerate the natural wear process and can already be (co-)responsible for the development of back pain in younger years.

A final remark:

Back pain usually has not just one, but several, partly different, causes. School medicine is not a universal remedy and cannot include everything that may be relevant with diagnostics. There are cases, where the understanding prevails, the pain is exclusively a physical manifestation and accordingly, is caused by physical ailments – in the meantime, it is known that this is not true and pain has many causes, also and particularly of the psychosocial nature. Therefore, healthy human understanding should always be used to weigh off whether a type of “examination marathon” is actually meaningful. The more honest you are with yourself and the way you deal with work, conflicts and the like, the more indications there are, in order to ultimately draw conclusions about the causes and apply the treatment method accordingly.