Low back pain patients need MRI scans like fish need bicycles

You’d be hard pressed to find a low back pain myth more busted than the MRI myth. MRI (and other imaging techniques, like X-ray) simply do not produce useful diagnostic information about low back pain, and do not lead to better treatment results. I’ve written about this extensively in the past, and compiled an impressive pile of scientific evidence supporting the point — that section of my low back pain e-book is already thicker with footnotes than any other place in all of SaveYourself.ca.

Then, from the The Lancet, along comes one study to rule them all. It’s just too good not to write about, too good not to add it to the pile. This is what we call a “sentinel” study: the last word on the subject for a long time. It offers the kind of scientific certainty that is only possible after rather a lot of other good science has already been done.

“Some clinicians do lumbar imaging routinely or in the absence of historical or clinical features suggestive of serious low back problems,” but this review of several studies of the subject clearly concludes that they really should not do that. It simply does no good, yet wastes resources and scares patients. As long as there are no signs of a serious underlying condition, “lumbar imaging for low back pain … does not improve clinical outcomes.”

Loud and clear message to doctors: Please stop sending low back patients for MRI scans unless you are really, really, really sure that it’s terribly important to check for something nasty.