Diagnostic Testing

Precise answers for the cause of your pain — because effective treatment starts with an accurate diagnosis

Pain is not the same for every patient. At Sweetwater Pain and Spine, we take a comprehensive, individualized approach to evaluation and diagnosis. Before recommending any procedure or treatment, we work to understand the specific source of your pain. Our goal is not just to manage symptoms — it is to find answers and create a targeted plan that addresses the root cause.

Clinical Evaluation

Every diagnostic workup at Sweetwater Pain and Spine begins with a thorough in-office evaluation. This is the foundation of everything that follows.

Comprehensive History and Physical Examination Our physicians spend significant time understanding the onset, character, location, and pattern of your pain, as well as any associated symptoms. This is combined with a detailed physical and neurological examination to guide all further testing and treatment decisions.

Review of Prior Medical Records and Imaging We review any relevant prior imaging, surgical reports, laboratory results, and treatment history to build a complete clinical picture — avoiding redundant testing and ensuring continuity of care.

Functional Assessment We assess how your pain affects your daily activities, work, sleep, and quality of life. This information helps us measure treatment success and personalize your care plan.

Electrodiagnostic Testing (EMG / Nerve Conduction Studies)

Electrodiagnostic studies are specialized in-office tests performed by our physicians to evaluate the health and function of nerves and muscles. These tests are essential for diagnosing a wide range of nerve and muscle conditions.

Electromyography (EMG) A small needle electrode is placed into specific muscles to measure electrical activity at rest and during contraction. EMG detects muscle damage caused by nerve injury, muscle disease (myopathy), or disorders affecting the nerve-muscle junction. Results help determine whether pain, weakness, or numbness is coming from a nerve or a muscle problem. Performed In-Office

📄 Patient Instructions

Nerve Conduction Studies (NCS) Small electrodes placed on the skin deliver a mild electrical stimulus to measure how fast and how well electrical signals travel along specific nerves. NCS identifies nerve damage, compression, or entrapment — such as in carpal tunnel syndrome, ulnar nerve entrapment, and peripheral neuropathy. Performed In-Office

📄 Patient Instructions

Conditions Commonly Diagnosed with EMG/NCS Carpal tunnel syndrome • Cubital tunnel syndrome (ulnar neuropathy) • Cervical or lumbar radiculopathy (pinched nerve in the neck or back) • Peripheral neuropathy • Plexopathy (brachial or lumbosacral) • Myopathy • Amyotrophic lateral sclerosis (ALS) screening • Complex or atypical nerve pain disorders

Imaging Studies

Advanced imaging is often a critical piece of the diagnostic puzzle, providing detailed views of the spine, joints, and soft tissues. We order and carefully review all imaging in the context of your history and examination findings.

MRI (Magnetic Resonance Imaging) The gold standard for evaluating soft tissues, intervertebral discs, spinal cord, and nerve roots. MRI is particularly useful for identifying disc herniations, spinal stenosis, nerve compression, tumors, and inflammatory conditions. No radiation is involved. Performed at Outside Imaging Center

X-Ray (Plain Radiography) The first line of imaging for evaluating bone alignment, fractures, arthritis, and degenerative joint changes. X-rays are quick, widely available, and helpful for assessing overall spinal structure and stability. Performed at Outside Imaging Center

CT Scan (Computed Tomography) Provides detailed cross-sectional images of bone and can be useful when MRI is contraindicated (e.g., certain pacemakers or implants), or for more precisely evaluating bony anatomy such as foraminal stenosis, fractures, or post-surgical changes. Performed at Outside Imaging Center

Diagnostic Ultrasound Real-time ultrasound imaging is used in-office to evaluate tendons, ligaments, muscles, nerves, and joints. It is particularly useful for detecting tendon tears, nerve entrapments, and soft tissue abnormalities, and can be performed dynamically during movement. Performed In-Office

Diagnostic Nerve Blocks and Injections

When imaging and physical examination cannot definitively identify the pain source, targeted injections serve a dual diagnostic and therapeutic role — helping to pinpoint the exact structure generating pain.

Medial Branch Blocks (Facet Joint Diagnostic Blocks) A small amount of local anesthetic is injected near the medial branch nerves that supply the facet joints of the cervical, thoracic, or lumbar spine. Significant pain relief following these blocks confirms facet joint disease as the pain source and identifies patients who may benefit from radiofrequency ablation.

📄 Lumbar Handout 📄 Cervical Handout

Selective Nerve Root Blocks (Transforaminal Epidural Injections) Injection of local anesthetic around a specific spinal nerve root helps confirm whether that nerve is the source of radiating arm or leg pain (radiculopathy). When pain relief is dramatic, this guides surgical or interventional planning with precision.

📄 Patient Handout

Sacroiliac (SI) Joint Diagnostic Injections The sacroiliac joint is a common and often under-recognized cause of lower back and buttock pain. A diagnostic injection with local anesthetic under fluoroscopic guidance helps confirm or rule out SI joint dysfunction before proceeding with longer-term treatments.

📄 Patient Handout

Lumbar Discography A specialized test in which contrast dye is injected directly into one or more spinal discs under fluoroscopic guidance. Discography is reserved for patients with suspected discogenic (disc-related) pain when MRI findings are inconclusive and surgical or interventional planning requires more precise information about which discs are symptomatic.

📄 Additional Information

Genicular Nerve Blocks (Diagnostic) Local anesthetic injections around the genicular nerves of the knee help confirm whether these nerves are contributing to chronic knee pain — particularly for patients who are not surgical candidates or who wish to explore non-surgical options before considering knee replacement.

📄 Patient Handout

Sympathetic Nerve Blocks (Diagnostic) Blocks of the stellate ganglion or lumbar sympathetic chain can confirm a sympathetically maintained pain syndrome — such as Complex Regional Pain Syndrome (CRPS) — by assessing whether pain decreases when the sympathetic nervous system is temporarily interrupted.

📄 Stellate Ganglion Handout

What To Expect at Your First Visit

Your first appointment at Sweetwater Pain and Spine is a diagnostic consultation. Here is how it typically unfolds:

Intake and Health History Review

Our team collects a detailed pain and medical history, including prior diagnoses, surgeries, imaging, and medications. Bringing all prior records and imaging discs to your appointment helps us start with a complete picture.

Physician Examination

Your physician performs a focused physical and neurological examination, evaluating range of motion, strength, sensation, reflexes, and specific pain provocation tests relevant to your symptoms.

Review of Existing Imaging

If you have had prior MRI, X-ray, or CT scans, your physician reviews these at your visit and explains what the findings mean in the context of your symptoms.

Diagnostic Plan and Recommendations

Based on your history and examination, your physician recommends any additional testing — such as electrodiagnostic studies, new imaging, or diagnostic injections — that will help identify your pain source.

Treatment Discussion

Once a diagnosis is established or strongly suspected, your physician reviews all available treatment options with you, explains the risks and benefits of each, and works with you to create a personalized care plan.

Have you been living with unexplained pain? Our fellowship-trained, board-certified physicians are here to find answers — and help you get back to doing what matters most.

Request a Consultation 📞 Call 775-870-1480