To diagnose a muscle strain or sprain your doctor will start with a complete history and physical exam . Your doctor will ask you to describe how you hurt your spine, where your spine hurts, how long the pain lasts, whether the pain radiates to any other part of your body, what movements make the pain feel better or worse, and whether you have ever had a previous spine injury. During the physical exam your doctor will check your strength, reflexes and range of motion in the affected area.
Lab tests are not usually needed in patients with a suspected muscle strain or sprain, unless the doctor is concerned about the possibility that your symptoms are being caused by another disease or condition such as rheumatoid arthritis or ankylosing spondylitis. To confirm a diagnosis of muscle strain or sprain, your doctor will probably take X-rays of your spine. Although soft tissues such as muscles, tendons, and ligaments do not show up on X-ray, doctors often order X-rays when you have back or neck pain to rule out the possibility that a spinal fracture, tumor, or degenerative joint disease could be causing or contributing to your pain. If you have an abnormal finding on X-ray, or if you do not respond to conservative treatment for your pain, your doctor may order other diagnostic tests to get a better look at your spine. These tests include a CT scan to further evaluate the vertebrae and facet joints, and an MRI to evaluate your intervertebral discs, ligaments, spinal cord, and nerve roots.