Scans for Low Back Pain: Good or Bad
April 19 2011
This was a really interesting post by Neil O’Connell at bodyinmind.org.This is such a relevant post because almost all of us will have some sort of low back pain in our life.
We now clearly know that abnormal findings on the x-ray and MRI ( like disc herniations, bulging disk, degenerating joints and so on) are clearly NOT related to the onset, severity, prognosis, or duration of low back pain.
This is now so well established that the American College of Physicians have come forward with clinical guidelines saying” Clinicians should not routinely obtain imaging or other diagnostic tests in patients with nonspecific low back pain”
Non-Specific low back pain is defined as low back pain that cannot reliably be attributed to a specific disease or spinal abnormality. 85% of the low back pain is due to non specific effects.
Imaging is only recommended for a minority of people whose low back pain can be attributed to specific pathology like cancer, compression fracture, spinal infection, cauda equina syndrome. progressive n neurological deficits and such.
Though these guidelines exist, physicians routinely get scans for patients. But the question is there any harm? The answer is YES.
I am not going though the design specifics of the study. You can check the link for more info.
- The results showed that no-MRI groups came off disability around 200% faster than the low-propensity early MRI subgroup!
- Medical costs were also dramatically different and in the same direction.
- The risk of having surgery for the no-MRI groups was reduced to 3% and 10% in comparison with the early MRI group (100%).
This post again emphasizes the powerful role of the psycho-social factors in pain which are still missing in our thinking about pain.
The Llnk to the post: http://bodyinmind.org/spinal-mri-and-back-pain/