Do I need imaging (X-ray, CT and or MRI) for my back pain?
Low back pain can be very painful and debilitating, so it makes sense that many experiencing back pain can be worried and want to know what is causing it.
However, unless there has been a traumatic incident, the answer is NO, imaging is not best practice or warranted in most instances. In some cases having a scan which is unnecessary can actually be detrimental to your long term management.
The best management for low back pain is regular, gentle activity. You may need to take it a bit easier during the initial stages, whilst trying to maintain your normal activities as much as you’re able. Short, frequent bouts of activity can be a good approach when your pain is severe.
In general back pain resolves quite quickly, but it can be normal for it to fluctuate, and come and go in those initial periods, don’t let this panic you.
Many findings that may be identified on imaging are common changes that we would expect to see over time and as we get older. As we age, just like, fine lines and wrinkles appearing on our skin, we see normal changes occur on X-ray, CT and MRI images. We can refer to these as the ‘Kisses of time,’ or ‘Wrinkles on the inside’.
Studies have also identified that many findings we see on images are present in large percentages of the population despite them not reporting or experiencing pain. Those findings can also be apparent on your asymptomatic (painless) side also.
Many of these findings would have to have been present for a long period of time, often prior to your acute episode of pain.
As we understand this to be the case it also suggests that pain is more complex than just identifying something on a scan, and we need to look at the entire picture of a person’s presentation. As these findings can at times lead to further tests that are unnecessary and perhaps even injections and surgery which may not be required.
Your health care provider is well equipped to determine if you require imaging and will identify ‘red flags’ that may alert them to circumstances where imaging is warranted, these may include;
A history of cancer
Unexplained weight loss
Fever or chills
Recent infection
Loss of bowel or bladder control
Numbness over the buttocks or genitals
Weakness in a leg
Unexplained weight loss
If you are are not experiencing any of the above symptoms, and you have not sustained a traumatic injury, in most cases you will not need any imaging.
If you have any questions regarding back pain management please get in contact or book an appointment online: https://www.katejohnsonosteo.com.au/book