Thus, it is important for clinicians to be aware of best practice regarding imaging for spinal pain, to understand alternative approaches to providing reassurance when imaging is unnecessary, and to have strategies for mitigating the potential negative impacts of spinal imaging in cases where imaging is nonetheless performed. Overuse of spinal imaging, misinterpretation of the clinical relevance of incidental findings and poor communication of relevant findings are likely to have adverse consequences for individual patient outcomes and healthcare expenditure. Much of the resulting concern is likely to be unwarranted, as many of the ‘abnormal’ features identified are likely to be found incidentally and represent ‘normal’, age-related changes that lack association with pain or prognosis.
4 However, imaging reports are not always reassuring and may even be perceived as threatening, given the high prevalence of aberrant findings. Spinal imaging is rarely indicated for patients presenting to primary care with a first episode of LBP, yet it is frequently requested to aid in diagnosis, rule out sinister pathology, guide treatment strategies or provide reassurance for the patient and clinician.
1,2 LBP is frequently benign and self-limiting however, a significant proportion of adults with acute LBP (10–40%) develop persistent and disabling symptoms.
Low back pain (LBP) is the most common musculoskeletal complaint seen in general practice in Australia, and is believed to affect the lives of one in seven to one in four Australians at any time.