By and large, the X-rays and imaging scans for back pain that doctors so frequently order fail to improve - and may even deter - patients' healing, a recent study has showed.

The research, carried out by researchers at the Oregon Health and Science University in Portland and published in the medical journal Lancet, reviewed six clinical studies involving a total of nearly 2,000 people with lower back pain. The findings revealed that patients receiving scans and X-rays failed to improve faster or experience less pain, depression or anxiety than those who didn't receive them. Indeed, the scanned seemed to suffer more pain than the non-scanned.

Lower back pain, as the second most common ailment for which people see their doctors (upper respiratory problems are first), consumes a big share of America's health care budget. Doctors send fully half of their back-pain patients out for a magnetic resonance imaging (MRI) scan or X-ray.

But the reason these scans can be hurtful is that, more often than not, they turn up problems that aren't connected with the back pain. Then these problems have to be investigated and perhaps treated, causing further anxiety, cost and maybe even pain. One study in the New England Journal of Medicine took 98 people with no back pain and gave them MRIs. The scans showed disc problems for two-thirds of these people with healthy backs.

"You can find lots of stuff on X-rays and MRIs like degenerative disks and arthritis, but these things are very weakly correlated with low back pain," said study author Roger Chou, associate professor of medicine at Oregon Health. "We think we're helping patients by doing a test, but we're adding cost, exposing people to radiation and people may be getting unnecessary surgery. They start to think of themselves as having a horrible back problem and they stop doing exercise and things that are good for them, when in reality, a lot of people have degenerative disks and arthritis and have no pain at all."

Chou recommended that patients demand that their doctors tell them why a scan should be had rather than addressing a back problem through pain medication and exercise while the problem heals on its own. Most back pain goes away within a month with minimal treatment. Only if it last longer than 30 days, Chou said, should a patient get checked for a possible infection or tumor.

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Source: http://well.blogs.nytimes.com/2009/02/06/scans-for-back-pain-ineffective/

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