Do You Need an X-ray for Low Back Pain?Patients who suffer from low back pain often feel frustrated when the cause of the pain is unclear, as is often the case. Sometimes people think that the more tests they have, the closer they will get to understanding the problem. However, X-rays for low back pain--a commonly prescribed diagnostic test--have a poor record of helping doctors figure out what's wrong. If that's the case, why are X-rays so commonly prescribed for this condition?
A recent study conducted in Norway suggests that patients who are given adequate information and support may be less likely to want unnecessary tests. In the study, 99 patients who received X-rays for low back pain were interviewed afterward. They ranged in age from 14 to 91 years old. They were asked to rate the importance of having an X-ray for their back pain. They were also asked about their views on the usefulness of and reasons for the X-rays. Other information was collected on the patients' condition.
Seventy-two percent of patients in the study said X-rays were very important for their condition. Men were more likely to think that X-rays were important than women. Those with worsening symptoms were more likely to think that, too. Interestingly, those who had the least real need for X-rays according to medical criteria were also more likely to think the X-rays important. This led researchers to believe that some patients may need more information or support from their doctors.
The researchers suggest that doctors should carefully explain why X-rays may not be helpful. Doctors should also try to understand the patients' specific concerns, frustrations, and fears. They suggest that sometimes patients may ask for X-rays out of anxiety or dissatisfaction with the doctor's explanation of their pain.
Overall, the researchers suggest that the real key is greater understanding between doctors and patients. If patients and doctors talked more about their concerns and beliefs about low back pain, fewer of these unnecessary tests might be done.
Ansgar Espeland, MD et al. Patients' Views on Importance and Usefulness of Plain Radiography for Low Back Pain. In Spine. June 15, 2001. Vol. 26. No. 12. Pp. 1356-1363.
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