Recommendations for decreasing imaging for low back pain, June 2016

Did you know that low back pain is one of the top 10 reasons for all physician visits in the U.S.? Low back pain affects approximately 31 million Americans. It can be caused by a variety of reasons, including age, occupation, pregnancy, injury, strains, skeletal irregularities, or osteoporosis.

Take into consideration that routine spinal imaging does not improve the health of patients and exposes patients to unnecessary harm from radiation and also possible adverse side effect from contrast (dye/agent) used. According to the American College of Physicians’ low back pain guidelines recommend imaging only for patients who have severe progressive neurologic (nervous system) deficits or symptoms that suggest a serious underlying condition.

The following tips are recommended for managing low back pain:

· Share your personal health history and family health history with your doctor to ensure appropriate testing. Tell your doctor about “red flags,” such as recent trauma, history of cancer, or loss of feeling/weakness/numbness in the lower limbs.

· Imaging studies can have harmful radiation effects that can cause damage if too many unnecessary tests are performed, and add unnecessary costs without benefit.

· Imaging tests, such as x-ray, CT or MRI, done less than four weeks from the onset of low back pain rarely improves pain and outcomes.

· Consider and try out alternatives:

1. Keep active! Staying in bed won’t help you get better faster. Don’t overdo it with strenuous activities, but walking and moving around help prevent your muscles from stiffening.
2. Apply heat to ease discomfort.
3. Adjust your sleeping position and also your sitting position (Get up and move every 30 minutes). Putting a pillow between your legs when sleeping on your side or a pillow under your knees when sleeping on your back can reduce back discomfort.
4. Use over-the-counter pain relievers recommended by your doctor.
5. Utilize physical therapy, massage and other pain relief measures.

· Exercise is the best way to relieve low back pain, strengthen your low back and abdominal muscles, and prevent future attacks. Check with your doctor before starting an exercise program.

If pain persists or worsens, contact your primary care physician.

Contributed by: The Physician Alliance, one of Michigan's largest physician organizations serving more than 2,200 physicians in southeast Michigan.

Source: American College of Radiology; American Academy of Family Physicians; Agency for Health Care Research & Policy; ChoosingWisely.org; American College of Physicians

This blog is for informational purposes only and should not be considered medical advice. Please consult your doctor for more information or if you have a medical concern.

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