To provide an accurate picture of what is going on, your doctor will normally use a range of diagnostic techniques depending on the suspected condition.
Initially your doctor will ask about your symptoms and conduct a thorough physical examination. Keeping a symptom diary with details of when the symptoms occur and what happens can be helpful.
You should also make sure you mention all of the symptoms, even those that may seem insignificant, such as altered sensations, numbness or tingling in any part of your body, unusual smells or tastes.
Your doctor may use a range of tests to investigate your symptoms in more detail. These include:
- Blood tests: To check things like your hormone levels, inflammatory markers or levels of Vitamin B12. If you have suspected ankylosing spondylistis it can check for the HLA-B27 gene.
- Neurophysiology tests: These are used to test the electrical functions of the brain, spinal cord and nerves. There are four types of neurophysiological tests including:
- EEG (electroencephalogram) tests to record electrical activity in the brain.
- EMG (electromyography) tests to record electrical activity in the muscles.
- Nerve conduction tests to record electrical signals travelling along the nerves in the limbs.
- Evoked potentials tests which record the electrical responses of the brain and spinal cord to stimulation of the senses.
- Corticosteroid injections: These may be used to relieve pain and inflammation in the nerve, helping the doctor to pinpoint exactly where the pain is occurring.
- Biopsy: If you have a suspected tumour, a small sample of tissue from the tumour will be taken and sent away to the laboratory for analysis. This will identify the type of tumour and help to determine the treatment plan.
- Spinal scans. You may be offered a CT or MRI scan and you may or may not need an injection during the procedure. This will be discussed with you beforehand. Sometimes, a dye is injected into the back of your hand to show up the blood vessels in your spine and produce more detailed pictures.
- A CT (computerised tomography) scan which uses a special type of X-ray to produce cross-sectional images of your spine. You will be asked to lie on a scanner table while the radiographer leaves the room. You will be able to talk via an intercom. The scanner table will pass through the scanner which will rotate around your head taking images. Up to 30 images may be taken. The procedure is painless and normally takes around 20-30 minutes or longer if you need an injection of dye.
- An MRI (magnetic resonance imaging) scan which uses powerful magnetic fields and radio waves to take detailed pictures of your spine and soft tissues. Prior to the scan, you should advise staff if you have a pacemaker, artificial heart valve or metallic implants such as joint replacements. You will be asked to remove dentures, jewellery and glasses as well as loose metal objects from pockets. Mobile phones, watches and bank cards should be left outside the room. During the scan you will lie on the scanner table when is then moved inside the scanner tunnel. Staff will talk to you on an intercom. An MRI scan is painless but is very noisy and some people can feel claustrophobic. Talk to staff if you are worried as they may be able to give you a sedative. A scan takes around 45 minutes or longer if you need an injection of dye.
- X-rays may be used to check for changes in your bone structure.