Routine use of scans in patients with lower back pain does not improve outcomes

Researchers looked at patients with acute back pain, the type most often seen by GPs. They assessed six trials of 1800 patients and found no benefit from the scans after a year of follow up.

Previous studies in the UK have shown similar results.

Researchers in this study looked at pain, function, quality of life, mental health, overall patient-reported improvement and patient satisfaction in the care they received for up to a year after their initial treatment.

All the patients were randomised to receive either immediate scans or standard clinical care.

Some of the standard care group were offered scans if they had not improved within three weeks.

There was no significant difference between the outcomes in patients who were offered immediate imaging with X-ray or MRI scans and usual clinical care either in the short-term - up to three months later, or the long-term - six to 12 months.

Researchers writing in The Lancet, the researchers say rates of MRI scans for back pain are rising according to figures from US medical programme Medicare.
They think patient expectations and preferences for imaging should be addressed, because in one trial 80% of patients with low back pain would undergo radiography if given the choice.