Use of Imaging Studies for Low Back Pain (LBP)
Clinical guidelines for treating patients with acute low back pain recommend against the use of imaging in the absence of red flags (in other words, indications of a serious underlying pathology such as a fracture or tumor). Unnecessary or routine imaging is problematic because it is not associated with improved outcomes and exposes patients to unnecessary harms such as radiation exposure and further unnecessary treatment.
- Recent trauma
- Intravenous drug abuse
- Neurological impairment
- Spinal infection
- Major organ transplant
- Prolonged use of corticosteroids
Hold off on doing imaging for low back pain within the first six weeks, unless red flags are present.
Consider alternative treatment options prior to ordering diagnostic imaging studies, such as:
- Nonsteroidal anti-inflammatory drugs.
- Non-pharmacologic treatment, such as heat and massage.
- Exercise to strengthen the core and low back or physical therapy.
Other available resources:
- National Committee for Quality Assurance — NCQA.org
- Choosing Wisely — Choosingwisely.org
- American Academy of Family Physicians — AAFP.org
April 2020 Anthem Provider News - Wisconsin