Imaging and Low Back Pain

If you’ve been alive on planet Earth for any amount of time, chances are you have experienced back pain at some point. 84% of adults experience back pain at some stage of their life according to research. In some cases, pain may come from an obvious source, a fall on an icy surface or a sport related injury. For a lot of people, however, pain can sneak up and appear for unknown reasons.

It’s only natural and logical to want to know why the pain is there and what caused it so you can avoid it in the future and hopefully correct or remedy the current issue. You would imagine that the use of medical imaging, such as X-Ray, MRI, CT scan etc. would be useful in this scenario. But what if the opposite was true. According to research this is absolutely the case for low back pain.

It turns out that imaging the back in hopes of diagnosing a pain causing issue produces many false alarms.

Signs of spine degeneration, including disc herniation are present in very high percentages of healthy people that don’t experience pain at all. These changes seen in imaging (degeneration and herniation) are best understood as just a part of the normal aging process of everyone.

Getting an MRI or X-Ray for back pain can give patients the idea that their back might be broken, crooked, out of place or fragile. When in fact most backs all contain these features. This can produce a lot of fear and prevent people from partaking in activities and exercise and may make their pain worse.

The reality is that low back pain can be greatly multifactorial, and the one or two “abnormalities” (but likely normal changes) found on imaging are just one small factor in a complex situation involving a patient’s habits, beliefs, stress factors, biomechanics, injury history etc. that can contribute to their pain.

Imaging such as MRI and X-Rays can be important and very useful, but it is now recommended that when dealing with back pain, imaging be reserved for severe and persistent back pain where there is weakness in the extremities or where cancer or an infection is suspected.

Osteopaths can help make sense of back pain and explain what might be causing your symptoms. They can help relieve pain through manual therapy techniques and give lifestyle and rehabilitation advice on the best strategies to overcome it.

Speak to an Osteopath today!

 

Written: Jared Cox

 

References

An online investigation into the impact of adding epidemiological information to imaging reports for low back pain
Yasmin Medalian 1G Lorimer Moseley 1Emma L Karran 1

Iatrogenic Consequences of Early Magnetic Resonance Imaging in Acute, Work-Related, Disabling Low Back Pain Barbara S. Webster, BSPT, PA-C, Ann Z. Bauer, MPH, YoonSun Choi, MA, Manuel Cifuentes, MD, MPH, ScD, and Glenn S. Pransky, MD, MOccH

Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
W. BrinjikjiP.H. LuetmerB. ComstockB.W. BresnahanL.E. ChenR.A. DeyoS. Halabi J.A. Turner,A.L. AvinsK. JamesJ.T. WaldD.F. Kallmes, and J.G. Jarvik