American Chiropractic Association Warns About Unnecessary Tests for Back Pain

American Chiropractic Association Warns About Unnecessary Tests for Back Pain

By Ed Coghlan.

If you have lower back pain, you no doubt have gone through a battery of tests and exams and maybe even procedures.

How many of them are necessary?

The American Chiropractic Association has some news out this week recommending that some common tests are unnecessary.

1.       In the absence of red flags, do not obtain spinal imaging (X-rays) for patients with acute low-back pain during the six weeks after the onset of pain. 

2.       Do not perform repeat spinal imaging to monitor patients’ progress. 

3.       Avoid prolonged or ongoing use of passive or palliative physical therapy treatments (such as heat, cold, electrical stimulation and ultrasound) for low-back pain unless they support the goal(s) of an active treatment plan. 

4.       Do not provide long-term pain management without psychosocial screening or assessment for possible related psychological disorders, most notably depression and anxiety.  

5.       Do not prescribe lumbar supports or braces for the long-term treatment or prevention of low-back pain.

ACA’s Choosing Wisely® recommendations were developed by the association’s Committee on Quality Assurance and Accountability, and approved by the ACA Board of Governors. 

“Conversations about what care patients truly need is a shared responsibility among all members of the health care team,” said Richard J. Baron, MD, president and CEO of the ABIM Foundation. “The American Chiropractic Association’s Choosing Wisely® list will help chiropractors across the country engage their patients in a dialogue about what care is best for them, and what we can do to reduce waste and overuse in our health care system.” 

Throughout its history chiropractic has been the subject of internal and external controversy and criticism. In recent years, the ACA has argued that chiropractic treatment should be part of the overall approach to dealing with pain, especially lower back pain.

If you have had back pain and gone to a chiropractor, share your observations.

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Authored by: Ed Coghlan

There are 11 comments for this article
  1. Jim in Pa at 9:24 pm

    I went to a chiropractor once, when I first started having back and neck pain. He did an xray of my neck. He said that I had the neck of a 70 year old, I was 50 at this time. There was a surgeon at the hospital who wanted to do carpal tunnel surgery on me, the chiropractor said my neck was causing the pain, not carpal tunnel syndrome. He wanted to try a couple of gentle adjustments on me. I let him and I was in horrible pain after the adjustments, I had to have ice on neck and it was the first time I experienced sciatica.

  2. Vanessa Gray at 3:12 am

    With regards to back pain it is never easy to bear, that is why people often seem taking different kinds of treatments. Some prefer natural therapies like chiropractic therapy whilst some prefer medical tests just like this. Both of these ways are good, the thing is which better suits on you.

  3. Wayne Schoeneberg at 2:24 pm

    I have had a wide range of experience with chiropractors. My first visit to a chiropractor was when I was about 12. I hurt my neck trying to do a back flip. My grandmother carted me off to the chiropractor and I was as good as new after one visit. As an adult I have injured my back a number of times playing various sports. Each time I went to a chiropractor and within a very brief course of treatment (the longest was ten visits) I was just fine. I have always felt that a chiropractor is the place to start when you have low back pain. I do not like taking medicines. I feel that they generally only mask the pain. None of my doctors ever did what I would call excessive testing or x-rays.

  4. Sheryl M Donnell at 2:38 pm

    Doesn’t this sound very self serving for chiropractors? It is basically an advertisement to avoid traditional medical treatment and seek chiropractic care for lower back pain. That said, not all chiropractors do no harm first. I have been severely injured by a few of them in the past. Unlike traditional medicine, they seem far less regulated. No thank you. I’ll stick with M. D.’s or D.O.’s.

  5. HAZZY at 8:37 am

    CHIROPRACTORS, MIGHT HELP SOME PEOPLE BUT NOT MYSELF, EVERY DISC IN MY NECK IS ARTHRITIC AND JUST HAD FOUR SHOTS IN MY NECK AND IT DIDNT DO A BID OF GOOD. PLUS THEY ARE BULGING AT C-3 TO C-6 !!! MY LOWER BACK AT L-4/L-5 IS FUSED AND EVERYTHING THING ABOVE AND BELOW THIS FUSION THE DISC’S ARE EITHER BULGING OR EVERY DISC IS ARTHRITIC SO A CHIROPRACTOR WILL MAKE IT WORSE. I TAKE PAIN MEDS BECAUSE I HAVE TO, BUT THE DRUG ADDICT’S ARE RUINING THIS OPTION FOR ME, I DO NOT BELIEVE IN MEDICAL MARIJUANA. THANKS

  6. Tandy Parker at 11:53 am

    Mike B…. if you look up and re-read number one…it says states …barring any red flags. Six weeks would be to give you time to heal muscle wound if you’re still in pain then an MRI would be in order. If your pain level was very high at onset that would be a red flag too.
    I’ve had an L5 S1 fusion and have metal in me. I have scoliosis and I have thoracic T12 bad disc I have three bad discs in my neck C4 C5 C6 C7. I see a chiropractor at least twice a month for sacral Release Technique for my CRPS and other ailments. It’s a non-invasive non-manipulative stretch that’s given me many benefits.

    In summary it sounds like this article was not written for you. I wish you health and healing.

  7. Mike b at 10:37 pm

    And i have been told never to go to the chiropractor and if i do and i tell them the issues im having in my back are due to multiple discs bulges and protrusions they wont even see me so all these people coming out with there opinions no one has a clear idea what to do now that this is in disarray and everyone is putting out there idea but sounds like the chiropractors are wanting us to see them and so they get payed thats all their worried there worried about and opiates are not even close to a gateway drug to heroin thats one of the most obserd things ive ever heard and disrespectful my MEDS was oxymorphone which worked on the brain and nerve receptors and it was pulled off the shelf due to some mis using it,thats like saying all muslims are terrorists,its just that untrue that a person uses a pain med for pain and he will likely misuse it by injecting it.Its never once crossed my mind and ive learned more about the misuse of the medication i was on for 8 years from drugs inc and what ive read about it after being taking off the shelf.All these accuasations are ridiculous.

  8. Mike b at 9:05 pm

    Is this for real-cause it just sounds crazy.Ive had MRI s done over the last 12 years on lumbar back i have at least 6-8 times and each year it shows something new on new on each report,thus showing that its getting worse not better,i also have pain in upper back as well in the thorasic area from t-2-t-8.I have at least 4-6 on my thorasic each year getting worse.
    I also have pain in my left knee sometimes it will just buckle from standing i have MRI s on it which shows a degenerative knee with other issues all showing its getting worse year by year.
    As well as right shoulder pain i had all three muscles torn rotator cuff issues had shouldar surgery in april 2011 its popping and clicking and aches every time i sleep.
    I had a mieogram and a discogram which showed i need a 4 disc fusion.
    Well ive refused surgery ive had over 100 injections in my back with no help or benifit.
    But i do have a back brace which helps i cant walk no longer than a block or stand for a half hour.Without pain radiating through my body ive gotten through all this so far from my pain meds,im a 14 year chronic pain patient now im back in pain due to the cdc guidelines on lowering pain medication.I have a back brace for lumbar area which helps with giving less pain in that area when i walk or stand.And a knee brace which helps my knee from inverting so it looks like someone from a insurance company wrote this to get out of having to pay for these procedures anymore or braces that do help with pain in these areas.
    And without all my MRI s we wouldnt have been able to understand why i kept telling the the dr its getting worse which proves i was right i know my body,and this all started when i was 26 im now 40 and i miss out on being able to take the kids to the park,or great america do you have any idea how it weighs on the mind with depression because they can never do what they used to day to day and try to put my shoes on and tell us how were supposed to feel and long term medication does help chronic pain patients to have what i would call a normal or regular day ive been the at home parent my wife works and since 2010 i had a son born in 2011 and thats how ive gotten by day to day and im a descent father instead of being in pain cause its helped me get by and able to not have surgery with all the negatives i face if i have surgery,they whoever wrote this article or made up this nonsense sound like a stone cold person with no heart or compassion for Chronic Pain Patients or others who have different cases and deal with pain every second of everyday weve now become a thorn somehow in the medical field or insurances to treat us inhumanely now.Wheres are rights as patients how did it come to this?
    We need to unite

  9. HAZZY at 11:20 am

    I was told never to see a Chiropractor, because i have a Fusion and metal and screws in my back. Plus i do not believe in Chiropractic care.

  10. Mark Ibsen at 8:00 am

    After surgery in 1983
    And
    1993 for disc disease,
    I found myself frustrated and confused by the lack of relief I found.
    As an ER Doctor
    I found myself unable to lift patients off gurneys
    And contribute in a physical way.
    This threatened my self image as an athlete and
    Active person
    And
    Grew my compassion for those in chronic pain, who are often left frustrated and confused, feeling betrayed.

    I went to massage
    And
    My massage therapist thought I would benefit from chiropractic.
    I did.

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