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IT'S YOUR BACK newsletter, Issue #005 -Diagnostic Imaging Tests and Treatment Exercise
September 15, 2014
Are Lower Back Imaging Tests Necessary?
A recent study by Cynthia Smith, M.D. and Patrick Alguire, M.D. ( http://www.hcplive.com/publications/internal-medicine-world-report/2014/August-2014/The-Value-of-Imaging-Studies-for-Acute-Nonspecific-Low-Back-Pain ) questions the necessity of imaging tests such as MRI, x-rays, and CT scans for diagnosing the cause of low back pain.
They conclude "spine imaging should be considered only in patients who have a ‘red flag,’ such as advanced age, history of trauma, history of cancer, and prolonged corticosteroid use, all of which have been associated with increased probability of either spinal fracture or malignancy.
They also state that other reasons for imaging tests are: pain longer than six weeks, fever, weight loss, and “progressive neurologic findings."
Granted, many imaging tests are performed far too frequently. However, medical doctors are looking for gross pathology (fractures, cancer) and I agree that from a medical perspective, if there are no “red flags” as stated above there will usually be insignificant findings on such tests.
As a chiropractor dealing with structure and function, many of these tests, especially plain x-rays, can often reveal very significant findings relating to the cause of or contribution to low back pain.
Some of these findings will only be obvious and measurable with x-ray analysis, i.e. short leg, pelvic tilt, and vertebral misalignments.
From a structural/functional perspective x-ray analysis can often be quite beneficial absent gross pathology. But be careful to put too much emphasis on imaging findings.
You can read more here: http://www.lowerbackpain-help.com/lumbar-x-ray.html
Can Exercise Cure Lower Back Pain?We are told time and time again, for lower back pain, we need to improve strength and increase flexibility. So off we go to the gym or rehab center to perform 6-8-12 or more weeks of exercise therapy only to end up with little or no improvement at the end of all our efforts. Truth is, strength and flexibility will help prevent low back pain but it has little to do with the elimination of or cure for low back pain.
Exercise is essential for low back pain prevention and should be part of our exercise routine. But to believe that it will cure low back pain is foolish.
Very often, even strength and flexibility will not prevent low back pain if structural imbalance, misalignment, and postural deficits are ignored. If strong backs prevented lower back pain, we would seldom see the strongest and most fit athletes with low back pain.
Truth is that these same strong people are seen in doctors’ offices and clinics as frequently as or even more frequently than the average or even weaker than average individual.
The keys to lower back pain management and prevention are: 1. Correct structural deficits. 2. Restore muscle function by eliminating trigger points. 3. Develop healthy postural habits. 4. Restore and maintain adequate strength required for daily activities. 5. Restore and maintain musculoskeletal balance throughout the body.
Yours for better health,
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