Study finds problems with back pain imaging use

January 31, 2011 2:56:44 PM PST
Backache is one of the most common physical ailments Americans complain about. A major doctoral organization is claiming that more testing may not be the best way to go.

Many people suffering from back pain go through a variety of tests ranging from x-rays, cat-scans, and MRI's, which researchers say are often performed unnecessarily.

The American College of Physicans has released a finding saying "a more careful and selective use of these tests would give patients better care, better outcomes and also reduce our costs."

Pain in the lower back gets many, if not most of us, most of the time. The reason for the pain is undetermined - age, loss of muscle elasticity and flexibility can contribute.

"Most people have lower back pain because of inactivity and poor posture," said Dr. Jeffrey Gross from Union Square Rehabilitation

Dr. Gross takes care of many patients with back pain.

"Most patients are better within a few weeks or a couple of months with treatment that can include rest, exercise or other activities such as physical therapy, and occasionally medication," said Dr. Gross. "But that's not often what patients expect. Most patients want and expect imaging tests, but these tests should be given only to very specific patients."

Today's report from the American College of Physicians says the evidence shows that "routine" imaging is unnecessary, wasteful and possibly harmful.

"Imaging tests usually lead to further unnecessary tests, referrals, follow-ups, and intervention that have no impact on outcome so the patients are needlessly exposed to radiation which can increase a patient's risk of cancer over time," said Dr. Amir Qaseem from the American College of Physicians.

Imaging may be necessary when there are new symptoms or neurological symptoms, or a serious disease is suspected.

Dr. Gross and the report both stress it's up to both doctors and patients to discuss what is best for the patient.

"It's very important that doctors and patients have a clear conversation about any medical test. What is the risk of the test? What is the benefit of the test and how will the test change the treatment plan? That is the most important question to answer," Gross said.

"Most patients do not want tests that are not beneficial and may be potentially harmful," said Dr. Qaseem.