Back Pain Management: the Case Against the Scan

Patients should consider getting medical imaging tests and scans only when medically necessary because of low levels of radiation and cancer risk.

For many patients and the clinicians treating them, the first instinct when developing acute back pain is to run to get an X-Ray or MRI to see if there is anything seriously wrong with their back. While this may seem like a sound idea or plan, it may not necessarily be in the best interest of your health to get a scan unless medically necessary. Now you are probably thinking as you are reading this, "how do I know exactly what is medically necessary?". Though each patient may be treated differently on a case by case basis, you should know two things, most cases of acute back pain resolve themselves on their own without any treatment at all, and all types of medical imaging will carry with it some level of risks. X-Ray tests will require your body to absorb some level of radiation, and MRI machines contain three different types of powerful Tesla coils that effect the electrons of the atoms of your body. Now before getting too scared about medical scans, you should know that the health risks are relatively low. On the other hand, you should consider putting some tests aside unless you are suffering from a back problem that will resolve itself on its own.

The American College of Physicians (ACP: in 2011 has published findings saying that medical imaging tests such as X-Ray, MRI, CT scan, and Nuclear Medicine may do more harm than good for many patients. There will be some degree of health risk associated with radiographic (medical imaging) procedures, and successful outcomes don't correlate to future success rates in treating back pain. A publication by the American College of Physicians states, "Routine imaging does not seem to improve clinical outcomes and exposes patients to unnecessary harms." In fact, though Americans are running to get medical pictures at a faster rate than before, these tests don't seem to lead to long term back pain relief. More tests and more pictures don't seem to correlate with future results.

AMA guidelines outlines recommend MRI (Medical Resonance Imaging), CT (Computed Tomography), and X-Ray only for patients suspected of having serious spinal or neurologic back problems that need to be treated immediately. Serious back problems that should be addressed immediately with medical scans include possible fracture as a result of accident or trauma, infection, other causes of fracture (such as osteoporosis), and rare conditions, such as cauda equine syndrome.

The vast majority of back pain sufferers should wait at least 1 month to see if the pain abates on its own before going under the camera to see what's wrong with them. Now you may be thinking, "how much is one X-Ray really going to hurt me? Millions of people are having them every day, and the general population does not seem to be the worse for wear as a result of it." True, the risks are relatively low, but they are there, and they should be considered by you and your doctor. You will get a small level of radiation from X-Ray and CT machines, and the cumulative effects of all the medical imaging tests could accumulate over the course of your lifetime. The cumulative effects of all these tests that cause your body to absorb low levels of radiation could contribute to a cancer risk.