
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.