Patients Overestimate Importance of X-Rays for Back

Contact:Megan KellerLippincott Williams & Wilkins(215) 521-8374[email protected]

DATE FOR RELEASE JUNE 15, 2001

PATIENTS OVERESTIMATE IMPORTANCE OF X-RAYS FOR BACK PAIN

PHILADELPHIA, PA June 15, 2001 - Even though x-rays usually aren't needed to diagnose the cause of low back pain, most patients rate them as "very important," reports a study in the June 15 issue of Spine.

Analyzing the reasons why may help in finding ways of reducing unnecessary use of x-rays (radiographs) for low back pain, according to a "patient-centered" study led by Dr. Ansgar Espeland of University of Bergen, Norway.

The researchers interviewed 99 patients undergoing x-rays because of low back pain. Seventy-two percent of patients said that having the x-ray examination was "very important." Patients for whom x-rays were probably unnecessary--based on standard medical criteria--were actually more likely to rate the test as important. Female patients and those whose back pain was getting worse were also more likely to rate x-rays as very important.

When asked why they thought x-rays were so important, the patients cited a wide range of reasons: some because the test had been recommended by their primary care doctor, others because they thought it would help explain their symptoms, and still others for emotional support or reassurance. For some patients, the reason why they needed x-rays was simple: "Because my back hurts!"

In truth, x-rays are usually unnecessary for patients with low back pain. In most cases, they provide little diagnostic information beyond that obtained by physical examination. X-rays performed without sound medical reasons incur unnecessary costs and radiation exposure. Depending on the criteria used, x-rays were considered inappropriate for 63% to 75% of patients in the study.

Based on their findings, Dr. Espeland and colleagues suggest some ways of reducing inappropriate x-rays. For example, doctors should explain that x-rays are usually not needed to diagnose the cause or decide on treatment for back pain. If the patient seems to need reassurance, the doctor should find other ways of providing it, rather than ordering an unnecessary test.

"Few studies of the management of low back pain have focused on the views and the needs of the patients," Dr. Espeland and colleagues write. They believe that addressing the issues of concern to patients with low back pain may help to reduce unnecessary use of x-rays while improving patient care.

Recognized internationally as the leading journal in its field, Spine reports on today's most important diagnostic and therapeutic advances regarding spinal pain, deformity, and disability. Distinguished by its broad scope of coverage and emphasis on patient care, this popular biweekly has earned must-read status in the orthopaedic community. For more information, call 1-800-638-3030 or visit www.spinejournal.com.

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