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How is pain diagnosed?

There is no way to tell how much pain a person has. No test can measure the intensity of pain, no imaging device can show pain, and no instrument can locate pain precisely. Sometimes, as in the case of headaches, physicians find that the best aid to diagnosis is the patient's own description of the type, duration, and location of pain. Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain. These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a patient with pain.

Physicians, however, do have a number of technologies they use to find the cause of pain. Primarily these include:

  • Electrodiagnostic procedures include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies. Information from EMG can help physicians tell precisely which muscles or nerves are affected by weakness or pain. Thin needles are inserted in muscles and a physician can see or listen to electrical signals displayed on an EMG machine. With nerve conduction studies the doctor uses two sets of electrodes (similar to those used during an electrocardiogram) that are placed on the skin over the muscles. The first set gives the patient a mild shock that stimulates the nerve that runs to that muscle. The second set of electrodes is used to make a recording of the nerve's electrical signals, and from this information the doctor can determine if there is nerve damage. EP tests also involve two sets of electrodes -- one set for stimulating a nerve (these electrodes are attached to a limb) and another set on the scalp for recording the speed of nerve signal transmission to the brain.
  • Imaging, especially magnetic resonance imaging or MRI, provides physicians with pictures of the body's structures and tissues. MRI uses magnetic fields and radio waves to differentiate between healthy and diseased tissue.
  • A neurological examination in which the physician tests movement, reflexes, sensation, balance, and coordination.
  • X-rays produce pictures of the body's structures, such as bones and joints.
Return to Chronic Pain

See what others are saying

Comment from: Pamela, 35-44 Female (Patient) Published: April 11

My chronic pain started in 2004. Pain started in lower back and left leg. I was diagnosed with degenerative disc disease, nerve damage, muscle spasms, anxiety and insomnia. In 2010 I got full disability. I had 2 surgeries. In 2011 I went to a pain management doctor, was told anxiety was in my head, did nerve block and steroid shots (all I"ve had done before, I told him that). By end of year he took me off all medicines (Lortab, Soma, Zanax, Ambien and Zanaflex). The reason I was given I was too young to be on medicine.

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Comment from: wilne tucker, 55-64 Female (Patient) Published: June 28

My chronic pain was diagnosed many years ago after I had a car accident several. I have been on almost every pain medication and nothing seems to help. I have a spinal cord stimulator implanted in my lower spine. It helps.

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Comment from: IamLove, 45-54 Female (Patient) Published: March 07

I have had many, many examinations over the years due to my chronic pain. I have had several EMGs on my arms. I have had my grip strength checked tons of times. I have had wrist X-rays three times. I recently had an MRI on my neck (where I do have degenerative disc disease, cervical stenosis, and bulging discs, but not much pain), which my current doctor thought was probably causing my bilateral arm pain. For so long it was diagnosed as tendonitis, but the neurologist I saw on Monday said that I have carpal tunnel syndrome due to hands-on tests and the results from my fourth EMG. It has been a long 18 years of chronic pain to discover this.

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