Relationship of Early Magnetic Resonance Imaging for Work-Related Acute Low Back Pain With Disability and Medical Utilization Outcomes

Abstract

The majority of cases had no early MRI indications. Results suggest that iatrogenic effects of early MRI are worse disability and increased medical costs and surgery, unrelated to severity.

Worsening Trends in the Management and Treatment of Back Pain

“…One study revealed that early MRI for acute back pain was associated with an eight-fold increased risk of surgery, while another found that regions with more MRIs do more surgeries, with 22% of the variability in spine surgery rates explained by rates of spine MRI use—more than twice the predictive power of patient characteristics. 46,47 …”

Variation among Primary Care Physicians in the Use of Imaging for Older Patients with Acute Low Back Pain

“…Imaging may detect abnormalities unrelated to the pain, leading to additional tests, interventions, and referrals that do not improve outcomes. 8,9 Cumulative low-level radiation exposure is associated with an increased risk of cancer, with about 1,200 additional future cases of cancer anticipated for the 2.2 million lumbar CT scans performed annually in the US. [10][11][12] Medical societies recommend against imaging for acute low back pain.…”

The direct cost burden of 13years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index

“…We could not determine whether the increase in severity of reported cases -a finding observed in 3 data sources -was due to the initial injury being more severe, more costly treatment (e.g., an increase in lost time due to increases in medical procedures, diagnostic tests, surgery or drugs prescribed than in the past (Webster, Bauer, Choi, Cifuentes, & Pransky, 2013;Webster & Cifuentes, 2010;Webster, Verma, Willetts, Hopcia, & Wasiak, 2011), or a decline in reporting of lower severity cases).…”