Screening for Low Back Pain and Sciatica

The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Screening Tests and Guidelines

There are no screening tests or screening guidelines for low back pain and sciatica.

Often, patients with pain may feel an urgent need to have a medical test. It is important to understand that medical tests are not routinely required for back pain and sciatica.

Most episodes of acute back pain resolve on their own over several weeks. In these cases, the information from an ]]>x-ray]]> or ]]>MRI scan]]> may not change the medical plan, and so these tests may be unnecessary. An MRI or x-ray is usually ordered if there is a plan to do a procedure or surgery, based on the result of the images.

Studies of medical imaging have demonstrated that MRI and x-ray may be too sensitive. They can often show abnormalities that are not truly significant, such as degenerated discs in individuals who do not even have symptoms. An improper medical test can lead to improper treatment and can greatly increase medical costs. It is important for such tests to be ordered appropriately.

References:

Boden, S. D.; Davis, D. O.; Dina, T. S.; Patronas, N. J.; and Wiesel, S. W.: Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J. Bone and Joint Surg . 72-A:403-408, March 1990.

Boden SD. The use of radiographic imaging studies in the evaluation of patients who have degenerative disorders of the lumbar spine. Journal of Bone & Joint Surgery - American Volume. 78(1):114-24, 1996 Jan.

Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373:463-472.

Conn's Current Therapy 2001 . 53rd ed. W.B. Saunders Company; 2001.

Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331:69-73.

Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#Spine . Accessed October 27, 2008.

Russo RB. Diagnosis of low back pain: role of imaging studies. Clinics in Occupational & Environmental Medicine . 5(3):571-89, vi, 2006.

Textbook of Primary Care Medicine . 3rd ed. Mosby, Inc.; 2001.

Zhou Y. Abdi S. Diagnosis and minimally invasive treatment of lumbar discogenic pain--a review of the literature. Clinical Journal of Pain . 22(5):468-81, 2006 Jun.

Last reviewed October 2008 by ]]>John C. Keel, MD]]>

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.