Back pain cannot be visualized or accurately quantified with current technology.  To provide an accurate diagnosis the attending physician must correlate the patient’s history, physical examination findings with diagnostic test results from studies such as blood testing, X-ray, CT, MRI, EMG and nerve studies.  The findings or impressions of most diagnostic imaging tests are based upon a description of structural changes.  It should be kept in mind that many medical terms (such as herniated disc) refer to radiographic findings seen on a CT scan or MRI scan, but these types of tests cannot currently determine the exact cause or accurately quantify the extent of back pain.

The causes of back pain are complex.  Despite numerous advances in medical care for back pain, it is often difficult at times to get an accurate diagnosis. While some spinal diagnoses are relatively straightforward (such as tumors, infections, or fractures), most conditions need greater investigation.  Sometimes physicians may disagree about the primary cause for back pain in an individual. The sooner an accurate diagnosis is rendered, the quicker the patient will begin receiving the right type of treatment.

Despite a battery of diagnostic tests sometimes a specific reason for a person's back pain cannot be confirmed.  However, if there is no apparent anatomical reason for the patient’s pain, the pain is still real from the patient’s perception and needs to be managed.