Modern technology has given us a myriad of ways to diagnose upper and lower back pain, most of which are non-invasive, which means no open surgery is required in order to “look at” the bone and nerves in your back. The only problem is that just because you may be invited by your doctor to have one of these diagnostic tests, it doesn’t guarantee finding the cause of back pain in our particular case.

Computerized Tomography (CT) Scan

Also called a CAT (computed axial tomography or computer aided tomography) scan, the CT scan, like the myelogram, is used to confirm a clinical diagnosis of operable back pain and help pinpoint its location.

Often done in conjunction with a myelogram, because the dye used in myelograms results in a clearer image, CT scans are particularly useful for providing pictures of the bony parts of the back.

Lying face up on a narrow, adjustable bed, the patient is slowly propelled through the “hole” of a doughnut-shaped scanner ring as the computer-controlled scanner revolves around the ring. Hundreds of thousands of scans are taken of thin transaxial slices of the spine, which are then translated by a computer into images. The results are cross-sectional views of areas as thin as one-fifth of an inch. The procedure, which involves less radiation than five traditional X-rays, takes an hour or more.

Magnetic Resonance Imaging (MRI)

This process, introduced in 1980, can produce extremely clear images of the back, not with radiation, but with magnetic and radio waves. The patient is placed on a narrow bed and slid head-first into the tunnel-like - and very noisy - scanner. A magnetic field affects charged particles in the hydrogen atoms of the body’s cells, and the particles react to the radio waves, which are analyzed by computer to produce an image.

MRIs can “see through” bone and reveal fluid-filled soft tissue in detail. That’s why MRIs are favored to confirm diagnoses of suspected soft-tissue (such as nerve) maladies, while CT scans are favored for those of the bones. MRI images can be either cross-sectional or lateral (lengthwise) views.

Because a powerful magnetic field is involved, MRI cannot be used on patients with pacemakers or other metal implants, or on those with intrauterine devices (lUDs).

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