As a primary Health Care Practitioner, people often present with acute low back pain and are unsure of what it is and how it happened. Many people commonly ask, what is causing this pain? And do I need to get a scan of my back?
To answer this, I often spend the session educating each client on what is happening with their body (after a thorough history and examination has led to a diagnosis). So today I thought I would share some basic information that helps shed light on when we need to get a scan on our painful backs.
Firstly… What is low back pain?
Low back pain is a broad term referring to pain in and around the lower portion of your spine (lumbar spine and sacrum). The vast majority of low back pain comes under the term “non-specific low back pain” which essentially means that there is no specific disease or problem causing the pain eg: fracture, cancer or infection etc. Most people will experience non-specific low back pain at some stage throughout their life. Some common examples of this are local disc pathology (without neurological symptoms) muscles strains, ligament sprains, joint inflammation. Studies have shown that it is hard to define which of these structures are contributing to the pain experienced by a patient and as a result they get classified as “non-specific”. It is recommended that scans are not needed in initial management of non-specific low back pain.
Will a scan tell me exactly what is wrong?
There have been many studies to show that findings on low back imaging does not correlate to pain or function, most often findings of degeneration are also found in the general population with no pain at all. Routine or immediate lumbar spine imaging for low back pain without indications of serious underlying conditions does not affect management or improve clinical outcomes. So basically now we know that having a scan may show some findings that may be common amongst people of a similar age and they may be not related to your current pain.
So When do I need a scan?
Red Flags….
Best evidence shows that unless there are any potentially dangerous symptoms (called Red Flags) associated with your pain, there is no need to get a scan within the first 6-12 weeks. Scans are indicated if certain symptoms or pain presentation are detected which could indicate a serious pathology. These are scanned for during your history and physical examination with your Osteopath.
No improvement or change in symptoms…
General first line treatment strategies for non-specific low back pain involve education, activity modification, relative rest, exercise prescription and hands on therapy coupled with pain management. If this does not help resolve the pain over a reasonable period of time (usually at least 4-6 weeks) then your Osteopath may send you for scans to investigate possible reasons for lack of improvement and if there is potential for further intervention like injection therapy or surgery.
Take home message….
The vast majority of non-specific low back pain can be managed without the need for imaging, your Osteopath will talk you through if and when it is indicated you may need a scan. The best evidence shows that early education and exercise intervention is the best course of management for low back pain. So if you are experiencing low back pain come and talk to us and we can guide you through it to get you back to doing what you love the most.
Click here to book an appointment with Mark online or contact our friendly team on 5255 5040 (OG) or 4202 0446 (L) to discuss how Mark can help you achieve your health goals!
