Saturday, 7 February 2009

MRI scans not useful for back pain

The routine use of MRI scans in patients with lower back pain does not improve their outcomes, US scientists say.

They looked at six trials including more than 1,800 patients and found no benefit from the scans when patients were followed for up to a year.

Previous studies in the UK have shown similar results.

The National Institute for Clinical Excellence (NICE) is expected to publish guidelines on the treatment of lower back pain in May.

The researchers said the results were most applicable to the type of acute lower back pain assessed by a GP.

They 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.

They did not find significant differences between 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.

Imaging in the first month of low back pain is not recommended in the US or in draft guidelines from NICE that were published in October.

Consider course of manual therapy
Consider structured exercise programme
Do not offer an X-ray
MRI only for suspected spinal fusion or other serious underlying condition

Therefore, its strange that so many MRIs and Xrays are being taken unnecessarily, exposing patients to potentially dangerous radiation - in a paper published in the Lancet, the researchers say rates of MRI scans for back pain are rising according to figures from US medical programme Medicare. I would say "follow the money trail" to see why this is taking place.

It is estimated that 40% to 50% of the population experience back pain in any given year.

The draft guidelines from NICE say X-ray and MRI investigations of the spine should be limited to when tumours, breaks, fusions or serious inflammation and infection is suspected.

It advises all people with lower back pain to "exercise, if necessary in supervised groups, and that doctors should be able to offer a course of manual therapy".
Most chiropractors offer this sort of care..
tho find your nearest chiropractor in the UK see

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