An acute episode of low back pain is defined as having pain for six weeks or less. Research has shown that scans do not improve the outcome of patients with acute low back pain. Instead there is evidence to suggest that unnecessary scans can result in poorer outcomes.
It is strongly discouraged by medical guidelines to use scans for most types of acute low back pain as it can produce false alarms. This is because scan results do not correlate with an individuals pain or disability. For example, disc bulges are highly common in individuals that do not experience any low back pain or disability. Another disadvantage to unnecessary scans is the increased risk of surgery. Studies have shown that individuals who undergo imaging in the first month of low back pain are more likely to have an increased risk of surgery as well as an increase in subsequent medical costs. Unnecessary scans can also result in poorer psychological outcomes and can result in fear-avoidance and catastrophizing behaviours and may also increase the duration of low back pain.
So when should I go for imaging?
Serious conditions causing low back pain are very rare (e.g. fractures, cancer and infection). Your physiotherapists will conduct a thorough subjective and physical assessment on your first appointment to identify the likelihood that you are presenting with these conditions. It is in these scenarios that scans would be indicated. In these conditions, delayed diagnosis is associated with poorer outcomes.
In summary, scans for low back pain may not be necessary and may actually result in poorer outcomes. If you are experiencing low back pain, you should consult a physiotherapist to identify the possible causes and treatment for your back pain. If you have any questions regarding low back pain and scans, or are experiencing low back pain, please do not hesitate to call our clinic at (02) 9681 3467.