Spine physicians utilize a variety of diagnostic tests to help identify the specific nature of spinal injuries and disorders.  Diagnostic tests are used to help identify or confirm the presence of abnormal function or an abnormal structural state. Testing can also help reveal complications associated with a spinal disorder.  Follow up diagnostic testing helps determine the pattern of progression or recovery.  It is used to guide therapy and measure therapeutic outcome.  There are many types of diagnostic tests available to evaluate the spine, the spinal cord and the integrity of the spinal nerves.  Common spinal diagnostic tests are reviewed.

Algometry:

Algometry is a method of measuring pain threshold relational to the degree of pressure applied to soft tissue.  Pressure algometry uses a pressure manometer to estimate pain thresholds an area where pressure is applied.  It provides quantitative measurements of pressure thresholds and pressure tolerances perceived and reported by the patient.  The algometer itself is a device, which has a pressure measurement tip which can be applied over a body region.  The algometer records the amount of pressure applied, which is correlated with the patient’s perception of pressure and reported level of discomfort or pain.  This technique is usually repeated over time and the test results are compared to determine if pain levels are diminishing, resolved or worsening in response to care.  Pressure induced pain thresholds provide a sensitive way to assess treatment outcome.  Pressure-pain-threshold testing offers acceptable levels of reliability and reproducibility. Algometry can be used to evaluate paraspinal tissue tenderness.

Autonomic Testing:

Your doctor may wish to determine whether your autonomic nervous system is functioning normally. The nervous system consists of motor, sensory and autonomic components. The autonomic portion of the nervous system controls and regulates vital functions such as blood pressure, blood flow, sweating, bowel and bladder function.  Certain disorders and diseases can compromise the autonomic nervous system in isolation, or as part of more neurological compromise.  In the second case, many functions of the nervous system, including autonomic, sensory and motor systems, may be affected, and autonomic testing can be used as a "marker" to evaluate disease. 

Autonomic testing is usually non-invasive and generally well tolerated. Some of the tests for autonomic function include evaluation of blood pressure, sweating, skin temperature and heart rate variability. Measurement of these functions can help determine whether the autonomic nervous system is working normally.

Blood pressure testing is done under different postural, breathing and exertional conditions. The ability to sweat on different areas of the body can be assessed and compared to normal ranges.  Skin temperature along with digit blood flow can be monitored during a variety of provocative procedures that will increase or decrease blood flow.  Electrocardiography (EKG) testing may be used to evaluate heart rate response and variability during different procedures.  Ambulatory electrocardiography (EKG) may be performed to address heart rate variability (R-R intervals).