What's Your Back Pain History?

Why does your back hurt? Some of the best clues to the cause of your back pain will come from your description of the pain. Here are eight important questions your doctor will ask to help diagnose the cause of your back pain.

Only about 2% of back pain episodes require immediate medical treatment. However, to rule out the possibility of a dangerous condition, doctors still need to ask certain questions routinely -- for example, whether you can relieve the pain by changing your position and whether you feel pain when you're not moving. Questions your doctor will ask include:

1. Where is the pain located? Is it confined to the lower back or does it radiate to the buttocks or legs? These questions check for sciatica.
2. How severe is the pain? For example, is the pain so excruciating that any movement is difficult or impossible? Can you go about your normal daily activities, even though the pain prevents vigorous exercise or activities associated with a lot of bending and twisting, such as gardening or golf? A good description of pain intensity can help the doctor determine its cause.
3. When did the pain begin? Was it related to an activity or an injury? If the pain follows an injury, it is less likely to be due to a slowly progressing condition, such as spinal stenosis.
4. What makes your back feel better or worse? For example, does lying down make it feel better? Does bending for ward to tie a shoe increase the pain? The pattern of pain may indicate whether a nerve is involved, possibly because of a disk herniation.
5. Have you had a prior episode of back pain? If so, how was it treated and how effective was the treatment? The condition may have recurred.
6. Do you have any other health problems? Weight loss and poor appetite, for example, raise the concern that cancer has spread to the vertebrae. In addition, some disorders, such as hyperthyroidism, can cause osteoporosis.
7. What medications do you take? Certain drugs, such as corticosteroids or anticonvulsants, can affect spinal bone mass.
8. What do you do for a living, and what kinds of exercise or other activities do you do? In what ways is the pain disabling? Muscle injury is frequently related to a particular activity.