Lower back pain is one of the most frequent concerns our Perth Chiropractors are faced with. For our patients that either experience prolonged symptoms or more severe discomfort than they normally experience, their first question may be "do I need a scan?" On the most part, many of the patients that consult with our Perth Chiropractors will not require a scan or any further investigations of their lower back pain. Generally the only reasons our Perth Chiropractors would require a scan is if they suspect serious pathology, (inclusive of cancer, infection, fracture) or any pathology causing a neurological deficit or impairment. This view is in line with many international guidelines for lower back pain.
Now even though most of the patients that consult with our Perth Chiropractors will not be experiencing any serious pathology, they may still request imaging. Whats the harm right? Well there are many researchers that have looked into this. In one study published in 2020, that looked into 405,965 patients, it actually found patients that utilised early scans had worse clinical outcomes. These clinical outcomes included increased frequency of spinal surgery, greater use of prescription opioids, increased final pain scores and overall greater costs for acute care treatment.
Now study looked into early scans. How about scans utilisation at all in Chiropractic care. Would you expect getting a scan to get you better clinical outcomes for your lower back pain. A more recent study published this year in Chiropractic & Manual Therapies, that included 2162 patients, looked into this. The study is titled "What are the effects of diagnostic imaging on clinical outcomes in patients with low back pain presenting for chiropractic care." Now what this study found, was fairly similar to the study mentioned earlier. Chiropractic patients referred for imaging had slightly higher back pain intensity at both a two-week and one-year check in. The patients disability scores at two-weeks was also slightly worse for those that utilised imaging.
So what does all of this mean? Firstly, you shouldn't now be scared to get a scan. The purpose of this is to inform patients that routine scans should not expected or utilised for lower back pain. Should your Perth Chiropractor request imaging, it is likely they are looking for something specific or wanting to rule out something specific.
As always should you have any questions in regards to Chiropractic care, our Perth Chiropractors are always here to help. Should you be experiencing lower back pain make an appointment to consult with our Perth Chiropractors, to get your pain sorted today!
Referenced Articles:
Jacobs, J.C., Jarvik, J.G., Chou, R. et al. Observational Study of the Downstream Consequences of Inappropriate MRI of the Lumbar Spine. J GEN INTERN MED35, 3605–3612 (2020). https://doi.org/10.1007/s11606-020-06181-7
Jenkins, H.J., Kongsted, A., French, S.D. et al. What are the effects of diagnostic imaging on clinical outcomes in patients with low back pain presenting for chiropractic care: a matched observational study. Chiropr Man Therap29, 46 (2021).