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Most X-Rays, Scans Unnecessary for Acute Low Back Pain
Date:1/31/2011

By Serena Gordon
HealthDay Reporter

MONDAY, Jan. 31 (HealthDay News) -- X-rays, CT scans and MRIs may be routinely ordered for people with low back pain, but often these tests are unnecessary, suggests new guidance from the American College of Physicians.

What's more, these imaging tests have the potential to cause harm by exposing people to unnecessary radiation and by uncovering abnormalities -- such as a bulging disc -- that may not be causing the symptoms.

However, once such abnormalities are uncovered, they may be treated, potentially with an unneeded surgery, experts say.

And then there's the matter of expense.

"Health-care costs are increasing unsustainably, and a crucial concern for everyone is how do we maintain or improve the quality of care without increasing costs? One way is for physicians to stop ordering tests that may not be beneficial," said Dr. Amir Qaseem, one of the authors of the back pain guidelines, and director of clinical policy in the medical education division of the American College of Physicians (ACP) in Philadelphia.

The new guidelines on diagnostic imaging for people with low back pain are published in the Feb. 1 issue of the Annals of Internal Medicine.

Almost everyone will experience back pain at some point in their lives, according to the U.S. National Institute for Neurological Disorders and Stroke. The costs of treating low back pain are staggering: the ACP guidelines estimate that about $90 billion is spent each year in the United States on low back pain. In 1997, the average cost of treating one patient with back or neck problems averaged $4,795, according to the ACP. By 2005, that amount had climbed to $6,096.

Imaging tests make up a significant portion of those costs. The bill doesn't only include the test, but follow-up that might occur afterward such as additional tests, referrals and additional treatments that sometimes include surgery.<
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