I have back pain - do I need a scan? (Part I)


This is a common question we get asked a lot here at PhysioQinetics and we are firm believers that a scan is not always necessary and here is why.

Research has shown that an X-ray for acute lower back pain is ineffective at showing medical professionals the extent of the injury or the level of pain experienced from it - unless you suspect a fracture from high-impact trauma. To put it simply, a spine that may visually look like it may have a deformity may be completely pain-free and one with severe pain may look 'normal' upon an x-ray. However what we do know is that the dose of radiation from an X-ray to the lower back is similar to that of 20 back to back transatlantic flights; therefore, it is best to avoid this level of exposure to radiation without good reasons.

Unfortunately the story is similar for the effectiveness of MRI scans. MRI scans are used to detect a disc bulge in the lower back and upon testing of people without back pain only 36% were found to have normal discs throughout the spine. The other 64% showed signs of a disc bulge but were completely without any symptoms. As such, visual evidence of a disc bulge on MRI does not necessarily mean that the disc can be blamed as the cause for back pain - it has to be matched with the patients symptoms before the disc bulge can be classed as the potential trigger of their back pain.

The NICE (National Institute for Health and Care Excellence) guidelines for lower back pain states that scans should only be considered with a referral to a spinal consultant, if surgery or further intervention is required.

In Part II, we will discuss how prevalent inappropriate use of X-rays are seen in some segments of the musculoskeletal healthcare industry.

For more information, please refer to the resources below: