A recent study out of Stanford Medical School showed that patients with low back pain who had an MRI performed were more likely to have surgery than their counter parts who didn’t undergo advanced imaging. This is concerning because previous studies have shown that increase surgery rates don’t improve patient outcomes for low back pain.
Low-back pain is the second most common reason for missed work after the common cold. It was the fifth-most common reason for physician visits in the United States, with 26.4 percent of adults reporting low-back pain for a day or more during a three-month period in 2002. More than 80 percent of low-back pain was diagnosed as nonspecific, a category that includes lumbar strains and sprains, degenerative disk disease and spinal instability.
It has been found in study after study that patients typically fair very well with conservative treatment of low back pain. Conservative low back pain therapies include but not limited to chiropractic, massage and exercise. The majority of patients that come to Compass don’t get advanced imaging unless I determine that is it completely necessary. Because I see low back pain cases all day I feel more comfortable with treating these conditions conservatively prior to ordering an MRI. If we’re not making progress with conservative we will pursue advanced imaging or a referral to another healthcare provider.
MRIs are a great advancement and have helped to diagnoses conditions that would have previously gone undiagnosed, but with most things you can have too much of a good thing. Since the advent of MRIs it has been easy to rely on the technology in place of the diagnostic skills of the clinician. It should come as no surprise that I see new people everyday that present to my office with low back pain. Some of these patients with low back pain require advanced imaging because they’re presenting with symptoms beyond back pain such as pain that radiates along with numbness and tingling. The majority of patients don’t require advanced imaging and a diagnosis can be rendered with0ut the additional cost and exposure associated with advanced imaging.
In order to make the correct diagnosis it often doesn’t require sexy high-tech gadgets, rather the oldest diagnostic tool known to man, listening. Most people who know me know that I love technology, but technology is an enhancement rather than a replacement for a skilled, compassionate doctor.
For more information about low back pain, visit our Back Pain Page.