Monday, July 6, 2009

On The Topic of X-rays

Every day I find interesting information across my desk and today found something that I thought I would share. it is the text of an article from the British Medical Journal. it's an article from 2001, but is still very relivent today. Many practitioners feel taking an x-ray is almost mandatory, but quite the contrary is true. I only take x-rays when I feel there are clinical symptoms that point to a possible tumor or fracture that I would like to diagnose. read the text below it's not that long.

Do You Have Low Back Pain? Forget the X-rays

Getting an x-ray to uncover the source of lower back pain does not reduce suffering. In fact, in a new study, patients who had an x-ray, or radiography, reported more pain 3 months later than those who did not have an x-ray.

There is no evidence that having radiography helps doctors to care for people with simple back pain.

There is even evidence that the very act of having an x-ray can, perhaps by appearing to increase the perception of severity, delay recovery.

Low back pain is a common medical problem, and doctors often x-ray the lower spine to diagnose the cause of the pain. In most cases, however, x-ray results do little to change the treatment of back pain.

Most of the time, x-rays are performed to reassure patients or doctors.

Interestingly, even though x-rays did not appear to help relieve back pain, more than 80% of patients in both groups said they would choose to have an x-ray if they could.

By 9 months, most of the differences between the groups diminished, although having an x-ray still did not appear to provide any benefits, the report indicates. Patients in the x-ray group tended to be more satisfied with their care, however.

The findings highlight the need to let people know that x-rays are of little use to most people with low back pain.

Since so many people believe that radiography is an essential feature of the management of back pain, there is a need for a campaign to inform the public.

When doctors order an x-ray to investigate low back pain, patients may interpret the move as a sign that they really are unwell, so they may be more likely to report pain and to think that the pain interferes with their activities.

British Medical Journal February 17, 2001; 322: 400-405

1 comment:

  1. Dr Hahn
    You know I know you are an excellent Doctor.
    I do have to strongly disagree with the BMJ. My strongest argument against thir article is this. As a medical doctor, if all I was going to do to my patient was give some home exercises or perscribe medication, what cause would I have to take films. nothing I would do as a result of my breif exam woudl effectively change the spine or nervous system. Because we as chiropractors, look for the cause of health problems, and persuantly deliver specific gentle adjustments to the spine we'd better know exactly what's going on in the spine. The chances of finding cancer or some other pathology is very low, but due to the fact we actually touch our patients the level of certianty we must have goes up. If all we did was mask pain with medicine then what reason would we have to take films.
    When the BMJ says that having xrays does little to effect out comes in Patient's, they mean medical patients. Chiropractic patients on the other hand, who know the state of the health of their spines, and follow our recommendations have excellent our comes. There is much research supporting that as well.
    Thanks Eric
    Dr Jason Kucma