Association of Early Imaging for Back Pain With Clinical Outcomes in Older Adults

Bel ağrısında tanı ve tedavi algoritması

“…Bu yaklaşım ile, sağlık kurumlarına başvuru sayısının azalması ve maliyetlerin düşürülmesi de amaçlanır. [45,46] Söz konusu tedavi, hasta eğitimi ve egzersiz programlarından oluşan bel okullarını, psikoterapiyi, bilişsel ve davranışsal tedaviyi, sosyal ve mesleki danışmanlık hizmetlerini ve daha önce sözü edilen biyo-yararlanım tekniklerini kapsar. [7,42,47] Uzman gözetiminde yapılan tedavi planlamasının, başarı oranlarını arttırdığı bilinmelidir.…”

The ineffectiveness of paracetamol for spinal pain provides opportunities to better manage low back pain

“…While structural changes on MRI are very common even at early ages, they correlate poorly with pain and disability, demonstrating that LBP is poorly related to structural pathology 3 4. In contrast, LBP is related to a wide range of factors which can vary between individuals across lifestyle, physical, social, psychological, pathoanatomical and genetic domains 5.…”

“…Reassuring people that LBP is rarely linked to structural damage, that pain does not equal harm and that their back is structurally sound (even if painful) can reduce fear, catastrophising and disability 3 6 7. Avoiding routine imaging for LBP unless it is very clearly indicated, and ensuring accurate interpretation of imaging, is essential 4. Providing an alternative explanation for LBP—where LBP is associated with sensitisation of the nervous system linked to modifiable risk factors including biomechanical stressors, inactivity, depressed mood, anxiety, stress, poor sleep and fatigue presents opportunities for self-management.…”

Low Back Imaging When Not Indicated: A Descriptive Cross-System Analysis

“…[1][2][3] Patients seeking primary care for low back pain often receive x-rays and other imaging studies, but such imaging rarely improves care and can incur unnecessary radiation exposure and costs. [4][5][6][7][8][9][10][11][12] Several national quality guidelines recommend that clinicians not order imaging tests for nonspecific low back pain. One Clinical Quality Measure (CQM) that is a metric of "Meaningful Use" of electronic health records (EHR), per the Centers for Medicare and Medicaid Services (CMS), is "Percentage of patients with a primary diagnosis of low back pain who did not have an imaging study ... within 28 days of diagnosis."…”