Picture this scenario: Seven days ago you had a really bad attack of back pain. You can hardly get out of bed, and getting dressed and in and out of the car is slow and painful. It’s making life seem miserable. You’re middle-aged but, other than this pain, are well.
When you visit your GP, after examining you, she says it appears to be “non-specific musculo-skeletal pain”, should settle with time, and that you should stay active.
“Shouldn’t you order me an x-ray to find out what it is?” you ask. “It is really bad!”
Not so long ago, getting an x-ray for acute back pain was the norm. Although it’s now known that they don’t help most cases, they are still used far more frequently than is necessary.
Acute non-specific low back pain is a very common problem that, most of the time, gets better without any treatment. We are not sure anything, except staying active, helps it resolve faster.
X-rays are only helpful to diagnose the rare causes of acute back pain such as cancer (spread from some other origin), infection (very rare nowadays), osteoporotic fractures in elderly folk, or exceptional narrowing of the spinal canal. Most of these have some clinical indications that doctors look out for.
X-rays not only have little to contribute, they have downsides too.
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