Back Pain scans for seniors does not improve outcomes
In the health care system it is common to have set guidelines which govern procedures when dealing with certain conditions such as back pain. These guidelines state that when an individual (over 65) reports back pain to their physician they are sent for a diagnostic imaging immediately.
A new study published in the March 17 issue of the Journal of the American Medical Association has found that this is not always beneficial.
The study involved 5,200 patients over the age of 65 who had back issues between 2011 and 2013. Of the original patient group 1,500 were sent for additional diagnostic imaging of their condition within six weeks of them notifying their physician.
The study team then evaluated medical records to analyse what kind of service patients used following their first visit.
The team then discovered that none of the patients who had been sent for early diagnostic imaging fared any better than patients who hadn’t.
Dr Jeffrey Karvik, professor of radiology, neurological surgery and health services at the University of Washington commented with the following:
“Older adults with back pain who seek care and get imaging within six weeks of their doctors visit for back pain do not have better outcomes than similar older adults who do not get early imaging. Although early imaging is not associated with better pain and function outcomes, it is associated with greater use of health care services, such as visits and injections”.
This does create questions about the current guideline system in place. With the current evidence from this study it does suggest that unnecessary scans and financial spend could be avoided if scans were only used in certain circumstances. However it is not possible for doctors to always see the route cause meaning it may be necessary to identify potential back issues via diagnostic imagery.
Dr. John Mafi, Internal medicine at Beth Israel Deaconess Medical Centre and Harvard Medical School in Boston commented on the findings of the study:
“There is a lot of overuse going on in health care and there is a general bias to do more, among both doctors and patients. But what’s being tackled here is not actually about overuse. Here, the physicians were not wrong. They were just following guidelines regarding seniors, which are grounded in the idea that as you age the likelihood that some serious problem is causing your back pain is higher than if you’re younger.”
 “Back Pain Scans May Do Little to Help Seniors”, Alan Mozes, WebMD news from HealthDay, http://www.webmd.com/back-pain/news/20150317/early-scans-for-back-pain-may-do-little-to-help-seniors
 “Early x-rays might not help elderly with new back pain”, Kathryn Doyle, Reuters, http://www.reuters.com/article/2015/03/17/us-pain-back-imaging-idUSKBN0MD1UT20150317
 “Early imaging for back pain in older adults not associated with better outcomes”, JAMA, Medical Express, http://medicalxpress.com/news/2015-03-early-imaging-pain-older-adults.html