Exams and Tests to Diagnose Spinal Stenosis
by Dr Mark McFarland DO of Orthopaedic & Spine Center
In my last blog post I outlined what spinal stenosis is and how it can affect you, causing severe back pain and neck pain. Today, we look at how spinal stenosis is diagnosed.
If you find you are experiencing spinal stenosis symptoms, I recommend that you make an appointment with a Fellowship-trained orthopaedic spine specialist who can help determine a diagnosis, if any, and a treatment plan. When you see me or one of my colleagues, we will discuss your medical history and symptoms then perform a physical exam. I will check your muscle strength, reflexes, sensation, balance, and circulation to help determine if you have spinal stenosis. The specific location of your symptoms can help me determine which nerves are affected.
After the physical exam, I may order tests to help confirm the diagnosis of spinal stenosis, including Magnetic Resonance Imaging (MRI). MRI is a method used by physicians to look inside the human body to obtain diagnostic information. Incorporating advanced technology, an MRI scan produces images of the anatomy to help physicians properly diagnose their patients’ conditions. At Orthopaedic & Spine Center, we have an open MRI, which is much more comfortable for our patients than the standard confining MRI design. It is rare for one of our patients to experience claustrophobia. Our MRI is also much quieter than the standard unit. MRI is the preferred method of diagnosing stenosis.
In addition to the MRI, I may also order testing of the patient’s nerves to assess any damage to the nerves caused by the spinal stenosis. This test is called a nerve-conduction study (NCS), and measures the response your nerves have to electrical stimulation. Several electrodes are taped to your skin, and a shock-emitting electrode is placed directly over the nerve we are studying. Mild electric pulses are delivered at one point on that nerve and then a recording electrode measures the reaction your nerve has to the stimulus. When the electrical pulse is applied you will feel a tingling sensation and twitching of the muscle. The recording electrode tracks the time it takes for the muscle to contract in response to the electrical pulse.