More than half the patients who see a doctor for back pain undergo X-rays, a CT or MRI scan. But new research shows scanning to find the source of back pain may do more harm than good.
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Researchers reviewed six clinical trials comprised of nearly 2,000 patients with lower back pain. The data indicated that patients who get scanned for back pain may end up with more pain than those who are left alone.
The problem is that back scans can turn up physical changes in the back that are not really causing any problem. One study from The New England Journal of Medicine gave 98 people with no back pain an MRI. Two thirds had MRI reports showing they had disk problems.
With a positive scan, people start to think of themselves as having a terrible back problems. They stop doing exercise and things that are good for them, when in reality, most people have degenerative disks and arthritis and have no pain at all.
Even if there is a documented herniated disk, 90% will be pain-free in six weeks anyway. So rather than immediately getting an MRI, a better criteria for a scan should be if back pain persists for longer than a month, or if symptoms suggest a more serious problem like an infection or tumor, which are actually quite rare.
David Dubin, MD. is an emergency room physician who serves as a medical advisor for several companies. Formerly president of Aon Medical Consultants, he has been helping employers and insurance companies develop innovative cost containment programs and reduce workers comp costs for over 20 years. He can be reached at: MD@WorkersCompKit.com or 503-753-0168.
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