Bone Scan for Undiagnosed Back Pain

Patient

Q: My daughter has been experiencing quite severe lower back pain over the last 3 to 4 months. The pain has caused her to be unable to walk without a cane for support. She describes the pain as constant dull ache with jabbing pain going up and down her spine. She has had periods where she blacks out when the pain hits and the last time she fell and could not feel her legs but they kept twitching and where ice cold, also her toe nails turned black. She recovered with rest but this has been on going and has kept her out of school. She had an xray of her back and an MRI of her neck that and back doctors say showed nothing. They are labelling her as having a mental disorder, or faking it and refuse to give her pain relief medication,but the pain is real enough that sometimes she has to be carried. She gets headaches, dizzyness. What could cause such pain yet not show on xrays.

Doctor

A:   If the source of pain is the back, I agree with the imaging ordered for the back.  An x ray would look at the bony structure of the spine and is a very good initial test.
The MRI looks at the soft tissue of the spine and is also a very good test.
The only test not done is a bone scan.  The bone scan involves injecting a tracer that is designed to bind to white blood cells and then taking pictures of the spine.  If there are any injured areas or areas where there is excessive cell turnover such as in cancer, it will be highlighted by this test.
If a physical diagnosis can not be found, the goal should be then to manage the pain.  The possibility of a psychological basis of pain should not be excluded.  A refferal to a local pain clinic would be appropriate.

Related Q&A

Q: Chronic lower back pain a right shoulder stuffiness

Q: I had an MRI for some back problems but it came back with this: "Small 1.3 cm lesion in the prepontine cistern, ...

Q: Recent MRI was given to me without results. I have to wait until later in the week to get them.

Q: 23 y.o. female had lower right back pain for about 1 year following a burning pain from bending over (I thought it wa...

Q: Hello, I'm Adriana, I just received MRI results of my brain, I'm 40 yrs old, suffer from migraines, tension headaches...

 
DOCTOR ADVISORY BOARD
218

Dr. James Obaji M.D.

  • 247 Reviews
  • Family Physician
173

Dr. Suneel Sharman M.D.

  • 190 Reviews
  • Family Physician
138

Dr. Pat Golden M.D.

  • 169 Reviews
  • Cardiologist
98

Dr. Kunaal Jindal M.D.

  • 112 Reviews
  • Plastic Surgeon
CNN
BBC
MSNBC
CBS
abcNews
FoxNews