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Getting an x-ray to uncover the source of lower back pain does
not reduce suffering. In fact, in a new study, patients who had
an x-ray, or radiography, reported more
pain 3 months later than those who did not have an x-ray.
There is no evidence that having radiography helps doctors to care
for people with simple back pain.
There is even evidence that the very act
of having an x-ray can, perhaps by appearing to increase the perception
of severity, delay recovery.
Low back pain is a common medical problem, and doctors often x-ray
the lower spine to diagnose the cause of the pain. In most cases,
however, x-ray results do little
to change the treatment of back pain.
Most of the time, x-rays are performed to reassure patients or
doctors.
Interestingly, even though x-rays did not appear to help relieve
back pain, more than 80% of patients in both groups said they would
choose to have an x-ray if they could.
By 9 months, most of the differences between the groups diminished,
although having an x-ray still did not
appear to provide any benefits, the report indicates.
Patients in the x-ray group tended to be more satisfied with their
care, however.
The findings highlight the need to let people know that x-rays
are of little use to most people with
low back pain.
Since so many people believe that radiography is an essential feature
of the management of back pain, there is a need for a campaign to
inform the public.
When doctors order an x-ray to investigate low back pain, patients
may interpret the move as a sign that they really are unwell, so
they may be more likely to report pain and to think that the pain
interferes with their activities.
British Medical Journal February
17, 2001; 322: 400-405
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