The routine use of expensive X-rays, MRI and CT in patients with low back pain would be unnecessary and, in the case of two of these reviews, exposes people to radiation, researchers said.
Back pain is one of the most common reasons for consulting the doctor and sick leave.
Experts say that while most patients had no serious condition that is causing the pain, doctors often order immediately imaging procedures that can detect problems such as herniated disks, muscle injuries, arthritis or fractures.
Dr. Roger Chou, of the Oregon Health and Science University in Portland, and colleagues evaluated the results of six studies that included 1,800 people with pain in his lower back or lumbar spine.
Patients who had no signs of a serious underlying cause but as a control immediately received no imaging did better than those for which standard treatment was applied but without imaging studies, the authors wrote in The Lancet.
The results correspond to the particular type of back pain which is usually evaluated by a physician, said the team. The authors urged doctors not to order x-rays, CT or resonances unless concrete signs of a problem.
The controls are often expensive imaging and x-rays and scans expose patients to low doses of radiation may be carcinogenic, the researchers added.
“If there are warning signs that indicate a serious cause of low back pain, the images are rarely helpful in guiding treatment,” said Dr. Michael Koch, University of Goettingen in Germany, who wrote a commentary accompanied the study.
“The images of routine checks for patients with pain in his lower back is a waste of resources for medical care,” added Koch. He also stressed that the controls for images “have some potentially serious side effects.”
“Exposure to radiation is a major public health issue, particularly in women, where controls for images of the lumbar spine to expose the ovaries to radiation,” said Koch.
Meanwhile, the expert noted that although not involved exposure to radiation, the MRI is very expensive.
“Some doctors perform a routine of the lumbar spine or without a clear indication that possibly point to reassure their patients and themselves, to meet the expectations of the patient on diagnostic tests, or other reasons, wrote the computer .
Patients who insist on being subjected to imaging procedures should be counseled about their usefulness in certain limited cases.