Very few low back pains need a scan

Low back pain is a raging problem, with 223.5 million cases globally, but very few low back pains need a scan.

However, 90-95% of low back pain can be clinically diagnosed as uncomplicated and extinguished with simple treatment.

‘Uncomplicated’ meaning an absence of serious pathology such as cauda equina syndrome, cancer, spinal fracture and infection.

Reassuringly, the incidence of serious pathology in low back pain is very low, between 5-10%

Clinicians such as GPs, physiotherapists, chiropractors, osteopaths all know how to handle low back pain safely. Health professionals that work with low back pain are specifically trained to take a detailed history and ask ‘special questions’ to rule out serious pathology appropriate for further investigation such as an xray, MRI or CT scan.

Listening to a patient’s story, clinicians can develop and test a clinical hypothesis with a physical examination.

Combining ‘what has been said’ with ‘what has been found’ clarifies management, including onward referral if appropriate.

If you are concerned about your low back pain, be sure to see your GP or a health professional for a thorough assessment to makes sure that “there’s no smoke without fire”.

As a physiotherapist that enjoys exploring movement and exercise, I can help low back pain and guide you back to what you love to do.

My clinic is in Blackwell (DL3 8QF) in Darlington, click on the contact form below to arrange a discovery call, to discuss how I can help you.

References:

Brinjikji, et al (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 36: 811 – 816

Ehrlich (2003) Low back pain. Bulletin of the World Health Organisation, 81: 671 – 676

N.I.C.E. (2022) Low back pain (without radiculopathy)

N.I.C.E. (2022) Sciatica (lumbar radiculopathy)

N.I.C.E. (2022) Red flag symptoms and signs

Further reading:
Do I need a scan? Probably not… Imaging (part 1) – do I need a scan?
Management of low back pain Imaging (part 3) – management of low back pain