The Role of Diagnostic Imaging for Low Back Pain

Study Title: Diagnostic Imaging for Low Back Pain: Advice for High-Value Health Care from the American College of Physicians
Authors: R. Chou, A. Qaseem, DK Owens et al.
Journal: Annals of Internal Medicine
Date: 2011

Summary: 

• My full review of this paper was recently posted on Research Review Service but since I feel strongly about its message, I thought it would be a good idea to provide you with a brief introduction. In concert with the high incidence of low back pain in today's society lies a relatively high rate of requisitions for diagnostic imaging of neuromusculoskeletal conditions pertaining to the lumbar spine. Unfortunately, the appropriateness of such imaging studies may be questionable at best for many of these conditions owing to the fact that the outcome of care often leads to similar results in those patients who have undergone "routine" imaging and those who have not regardless of whether such tests were performed. Certainly, such imaging may be required for those patients suffering from severe and /  or progressive neurological deficits as well as for those presenting with serious underlying conditions however, more often than not, those patients presenting in general family, chiropractic or rehabilitation practices may do well without the unnecessary doses of radiation and costs to the health care systems. This best practice advice paper provided by the Clinical Guidelines Committee of the American College of Physicians provides the medical reader with a summary of the current literature pertaining to the utility of diagnostic imaging for low back pain and advises on the rationale behind evidence-informed decision making when a patient presents with low back pain symptoms. Utilizing results from high-quality studies, suggestions are made for cost worthy diagnostic protocols and advice is given on the potential harms and benefits of radiological procedures. Additionally, a valuable summary for patients has also been provided of which can be easily accessed here.

R. Chou, A. Qaseem, DK. Owens et al. (2011). Diagnostic imaging for low back pain: Advice for high-value health care from the american college of physicians. Annals of Internal Medicine, 154; 181-189