INFORMED APPROPRIATE IMAGING FOR LOW BACK PAIN MANAGEMENT: A NARRATIVE REVIEW

Review written by Todd Hargrove info

BACKGROUND & OBJECTIVE

Imaging for low back pain (LBP) is often overused in clinical practice, increasing medical costs and potential harm to the client. The problem of overuse has continued to get worse, even after numerous published guidelines on the topic. This review describes the recent guidelines for imaging in LBP and updates the available evidence on relevance of degenerative spine abnormalities for LBP. Following are the major points of interest from the review.

LOW BACK PAIN FACTS

  • LBP affects up to two-thirds of adults at some point in their lives.
  • LBP patients can be grouped into one of the following categories: (1) nonspecific LBP; (2) LBP associated with radiculopathy or spinal stenosis; (3) LBP referred from a non-spinal source or (4) LBP associated with other specific spinal causes.
  • At least 70% of LBP is classified as non-specific, meaning a specific nociceptive source cannot be identified.
  • Most acute episodes of LBP are self-limiting, with both pain and function improving substantially in the first 4 weeks.
  • Most cases of radiculopathy are self-limiting, and symptoms resolve over the course of weeks to months.

THE ROLE OF IMAGING IN LOW BACK PAIN TREATMENT

  • Lumbar imaging abnormalities are common in persons without pain, and poorly correlate with pain.
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