Experts say X-rays, scans for lower back pain lack support

The American College of Physicians (ACP) announced new guidelines for the assessment of lower back pain that call for fewer imaging scans. According to the ACP “best practice advice,” routine, imaging such as X-rays and CT or MRI scans often reveal abnormalities that are not, in fact, life-threatening. This can lead to a series of unnecessary follow-up tests that drive up health care costs and expose patients to needless radiation. Most cases of lower back pain are caused by strain on the bones, muscles or ligaments and can be alleviated within a few days using over-the-counter pain relievers. “Something like that can be identified by the physician taking a good plain old medical history,” Dr. Amir Qaseem, ACP director of clinical policy in medical education, told The New York Times, adding that X-rays and scans “should be reserved for selective high-risk patients who have serious symptoms.”

ACSH’s Dr. Gilbert Ross adds that “X-rays and scans rarely reveal anything in the absence of focal neurological findings, such as weakness of a particular muscle group and bladder dysfunction. These are semi-urgent findings that need to be addressed immediately.”