70-80% adults have experienced acute back pain, almost 30% seek medical attention, and this problem is one of the commonest reasons for a doctors’ office visit.
Most cases are caused by sprains or tears in one of the numerous muscles or ligaments in the back triggered by twisting or lifting something heavy.
These “soft tissue” injuries will usually improve on their own within a few weeks with anti-inflammatory medications and physical therapy.
However a recent study showed that more and more such patients are getting unnecessary imaging studies right away leading to surgeries and other invasive procedures that they don’t need.
Possible reasons cited for the necessary procedures include patient expectations and financial incentives for doctors.
Doctors shouldn’t immediately order an MRI or CT scan to determine the cause of back pain if a patient doesn’t have any red flags such as tingling in the legs — a sign of a nerve problem such as spinal stenosis — or a previous history of cancer.
Otherwise, imaging studies ordered for nonspecific back pain may reveal incidental disk problems, the result of aging, and not the cause of the symptoms.
This will then often lead to unnecessary and unproven interventional pain management procedures.
Most back pain patients simply need to be told that their pain will improve with antiinflammatory medications, physical therapy, massage therapy, and/or supervised exercise programs.
However, in the words of Dr. John Mafi, one of the study’s authors, “it takes longer to sit and reassure patients that their pain will likely resolve on its own than it does to order an MRI.”