New guidelines from the American College of Physicians say imaging tests for acute lower back pain may do more harm than good.
Back pain is one of the most common reasons for visiting a doctor’s office. But about 85 percent of the time, the pain can’t be attributed to anything specific and usually goes away in a month.
That’s why some physicians are saying routine X-rays, MRIs and CT scans for pain contribute to high health-care costs and don’t provide a diagnosis.
Amir Qaseem with ACP helped write the guidelines. He said an imaging test may show abnormalities that don’t even contribute to back pain.
“Routine imagining can lead to a series of unnecessary additional tests, follow-ups, referrals and may result in an invasive procedure that may be of questionable benefit and may not even improve patient outcomes,” said Qaseem.
He said patients with lasting symptoms of a more serious condition should be screened after a proper exam and reviewing medical history.
Dr. Alan Hilibrand with the Rothman Institute didn’t work on the guidelines. While he supports the protocol, he admits there is a legitimate fear of not running tests for both patients and doctors.
“Patients will be unhappy, let’s say in quotes ‘nothing was done’ to help them,” he said. “Also, because the ongoing fear that physicians have of missing a cancer or an infection and the results of that, both in terms of a bad outcome for the patient and also a medical liability aspect.”
According to the American College of Physicians, most acute lower back pain goes away on its own with medication and exercise.
The guidelines suggest people should wait four weeks before getting an X-ray or MRI.