The Role of Imaging for Lower Back Pain

Have you recently wanted some medical imaging to work out what the cause of your pain is? Only to be knocked back by your healthcare professional who said you don’t need it?

This situation can be confronting and frustrating.

I’d like to explain why it might be happening.

Firstly, LBP imaging doesn’t tell is a whole lot about the cause of pain. It can a pathology but it can’t tell us if that pathology is the cause of the pain.

A wise radiographer once said to me “if I had a machine that could see pain I’d be a rich man.”

Don’t get me wrong, imaging is still very helpful when it comes to diagnosing some of the more serious conditions like fracture or tumour however there are usually indications that this might be the case and health care professionals are always on the lookout for. These are known as red flags.

The problem with imaging is it can create more problems than it solves.

Often imaging will expose spinal pathologies that are considered a normal part of the aging process which starts as early as 20 years old- so yes not really AGEING aging but you know what I mean. Often these normal spinal changes get blamed for the pain and being degenerative in nature leads to people losing hope that their symptoms will ever improve.

But we know people WITHOUT low back pain also have these degenerative spinal changes, so we now understand that these findings are not always associated with pain.

So, if your healthcare professional doesn’t think you need a scan this is great news. It probably means that you have no red flags and that your symptoms indicate further diagnosis is not required.

The other side to this is that studies have shown worse outcomes for people who get scans for low back pain compared to those who didn’t. Not to mention the financial costs and exposure to radiation.

And if you have had a scan or need one then it’s obviously indicated and can give you piece of mind. It is important to take the time and understand what your results indicate may potentially have been there for a long time before the pain even started.

So at the end of the day, listen to your healthcare team. They really do have your best interest at heart and understand when and why imaging may be required. And if you disagree have a conversation and look to understand why. This will give you all the information you need so that you can make an informed decision together.

At the end of the day, getting on with your treatment plan and restoring range of motion and movement will allow you to start feeling better sooner.

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