Blood Testing

Blood testing is often performed as part of the evaluation of back pain with or without related nerve compromise.  Specialized blood tests can help a physician determine if there are laboratory indicators for those conditions that might be contributing to a back problem.  One of the most common blood tests performed is the complete blood count (CBC).  This is a test performed to evaluate the level and types of blood cells.  The total white blood cell (WBC) count and the pattern of white blood cells help determine whether there may be an infection that may involve the spine.  The CBC is also used to rule out various types of anemia’s that may occur as a result of bone marrow disease in the spine.  The CBC can also help determine whether there is an inflammatory process.

Another common test, the erythrocyte sedimentation rate (ESR) is a blood test used to quantify the degree of systemic inflammation.  The ESR test serves as an important bio-marker of inflammation.  It is often evaluated when there is a spinal infection.

Another category of blood testing is tissue typing.  The presence of a specific genetic marker called HLA-B27 in the blood can help a physician identify the possibility of ankylosing spondylitis involving the spine.  This is a form of arthritis that principally affects the spine and sacroiliac joints.  There are various types of arthritic disorders associated with the presence of HLA-B27. Although, the presence of this genetic marker is more common in individuals with certain arthritic disorders, its presence does not mean that it is inevitable that a disease process will develop.

A metabolic profile is often performed to help rule out organ (internal) disease that may cause secondary back pain.  A urinalysis may be performed to help determine whether there is a urinary tract infection, kidney infection or other forms of kidney problems that might contribute to referred flank or back pain.  A comprehensive blood test, often referred to as a connective tissue profile, may be performed to determine whether there is a disease process compromising connective tissues of the spine or extremities.  The typical connective tissue profile includes a variety of tests such as an anti-nuclear antibody screen (ANA) and rheumatoid factor (RF).  There are many types of specialized anti-nuclear antibody testing.  Benign and malignant prostatic disorders can refer pain to the spine and in the case of cancer may metastasize to the spine.  The prostatic specific antigen (PSA) is a widely used test, a laboratory indicator of prostate problems and is often ordered by spine specialists.