How is chronic low back pain diagnosed?

To diagnose chronic lower back pain and create an effective treatment plan, a healthcare provider will perform a medical history evaluation and thorough physical and neuromuscular exams.^[1] The following tests may also be performed to diagnose chronic low back pain: Imaging exams such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) can be used to check the spine for specific injuries. However, in the absence of red flags that indicate neurological problems, such as problems with bowel or bladder function, imaging is not recommended within the first 6 weeks of developing back pain. This is because imaging tests are often inconclusive. People without back pain can have abnormal imaging findings, and people with severe back pain may have nonspecific imaging results.^[1] Early imaging can potentially increase the likelihood of surgery that does not improve patient outcomes, as noted in one study that found patients undergoing early MRI imaging were twice as likely to have surgery compared to those who did not.^[2] In cases of suspected lumbar radiculopathy, electromyography (EMG) may also be performed to rule out other other neurological conditions with similar symptoms.^[3] Blood tests for inflammatory biomarkers such as blood cell counts, erythrocyte sedimentation rate, and C-reactive protein levels may also be performed to check for infections that may be causing the low back pain.