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Back pain

Tests for Most Low-Back Pain Are Worthless

Wednesday, February 11, 2009 by: Sherry Baker, Health Sciences Editor
Tags: back pain, health news, Natural News

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(NewsTarget) Suffering from pain in your lower back? You're not alone. According to the American Academy of Physical Medicine and Rehabilitation, low-back pain is the most common form of physical disability in the U.S. In fact, an estimated 80 percent of all Americans will suffer from back pain at some time in their lives. And when they go to their doctors for help, physicians often immediately order X-rays, MRIs or CT scans of the back.

But new research just published in the journal The Lancet by scientists from Oregon Evidence-Based Practice Center at Oregon Health and Science University (OHSU) concludes those tests are worthless -- as well as being expensive -- for most patients with low-back pain. The regular use of radiography, MRI or CT scans in patients with low-back pain doesn't improve their outcome, the researchers report. Moreover, having those imaging tests can make the condition worse by leading to unnecessary surgery.

"Our study shows that performing routine X-rays or MRIs for patients with low-back pain does not lead to improved pain, function or anxiety level, and there were even some trends toward worse outcomes," explained Roger Chou, M.D., lead author and scientific director of the Oregon Evidence-Based Practice Center at OHSU, in a statement to media. "Clinicians may think they are helping patients by doing routine X-rays or MRIs, but these diagnostic tests increase medical costs, can result in unnecessary surgeries or other invasive procedures, and may cause patients to stop being active -- probably the best thing for back health -- because they are worried about common findings such as degenerated discs or arthritis, not understanding that these are very weakly associated with back pain."

For their study, Dr. Chou and his research team conducted a meta-analysis of randomized controlled trials that compared immediate back imaging with CTs, MRIs or X-rays to regular care without any immediate imaging. In all, the OSHU researchers looked at six trials involving more than 1,800 patients to find out what outcomes they had, such as their degree of pain and function, quality of life, mental health, overall patient-reported improvement, and patient satisfaction.

The results? The investigators found no significant differences between people who had been sent for immediate imaging and those who had received standard clinical care without imaging. The only exception was in those patients who exhibited features of a serious underlying condition that are obvious to the physician during an exam.

In the press statement, the OSHU scientists said doctors treating patients with acute or subacute low-back pain and without features suggesting a serious underlying condition should refrain from routine, immediate lumbar imaging. "Rates of utilization of lumbar MRI are increasing, and implementation of diagnostic-imaging guidelines for low-back pain remains a challenge. However, clinicians are more likely to adhere to guideline recommendations about lumbar imaging now that these are supported by consistent evidence from higher-quality randomized controlled trials," they said.

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About the author

Sherry Baker is a widely published writer whose work has appeared in Newsweek, Health, the Atlanta Journal and Constitution, Yoga Journal, Optometry, Atlanta, Arthritis Today, Natural Healing Newsletter, OMNI, UCLA's "Healthy Years" newsletter, Mount Sinai School of Medicine's "Focus on Health Aging" newsletter, the Cleveland Clinic's "Men's Health Advisor" newsletter and many others.

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