In some rare cases x-rays and more advanced imaging such as MRI’s and CT scans are needed in order to rule out an underlying pathology that may be causing you back pain, such as; cancer, infections, fractures, systemic arthritities such as Rheumatoid arthritis etc…
These instances are only very rare and for the most part imaging is not needed for non specific or mechanical type back pain, However an assessment by a chiropractor or physiotherapist or general practitioner may be needed to determine if further investigations may be required.
A 2009 study, published in the lancet found that routine imaging performed on low back pain patients, without the clinical feature of an serious underlying problem did not improve outcomes in these patients
(1), another study concluded ” Structural variables on both MRI and discography testing at baseline had only weak association with back pain episodes and no association with disability or future medical care.”
(2) This basically means that findings on MRI’s even when considered moderate to severe that would normally be associated with pain such as disc degeneration and related conditions did relate to back pain severity; and are more than likely a coincidental finding. Interestingly enough the researches found psychological factors such as fear avoidance behaviors and anxiety were better a predicting low back pain symptoms.
There is also evidence to suggest, that in fact; taking imaging may worsen the outcomes experienced as putting a label such as spinal degeneration, spondylolisthesis and spondyolysis may only add to the physchological factors associated with chronic low back. I have personally encountered situations where patients had unnecessary imaging taken by a professional treating them for back pain,
Who were given a diagnosis and were told that would need regular treatment for an extended period of time some over a year just so there problem wouldn’t deteriorate even further. Obviously this is just a case of a dishonest therapist or practitioner motivated by greed, fortunately; to my knowledge anyway, most professionals do not participate in this practice; and our Sydney chiropractor utilizes medical evidence based guidelines when ordering further imaging.
At Sydney Chiropractic and Massage, our only goal is to have you pain free in the shortest time possible. We achieve this by combining one of the more effective muscle and joint treatments, myotherapy (SLM) and chiropractic respectively; and we aim to empower you with the right tools and knowledge so you can take control of your own back pain without the need foe excessive treatment. Our Sydney chiropractor will not order any unnecessary or expensive imaging unless it is clinically appropriate.
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1. Chou R., Fu R., Carrino J., Deyo R., Imaging strategies for low-back pain: systematic review and meta-analysis. The Lancet, Vol 373, No. 9662 p463–472, 7 February 2009
2. Webster S, Cifuentes M., Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes. J Occup Environ Med. 2010 Sep;52(9)