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Journal Club: Low Back Pain Edition

11/16/2020

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Every so often an article comes along that really makes you think and ultimately changes how you view your practice. Periodically, an article comes along that sheds the light of understanding to help improve your practice and patient education. “Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Cause More Harm Than Good” by Tim Flynn accomplished all the aforementioned criteria for me. Just read a portion of the synopsis and you can see why it’s an important article.

“The rate of lumbar spine magnetic resonance imaging in the United States is growing at an alarming rate, despite evidence that it is not accompanied by improved patient outcomes. Over-utilization of lumbar imaging in individuals with low back pain correlates with, and likely contributes to, a 2- to 3-fold increase in surgical rates over the last 10 years. Furthermore, a patient’s knowledge of imaging abnormalities can actually decrease self-perception of health and may lead to fear-avoidance and catastrophizing behaviors that may predispose people to chronicity.” You can view or download the article below

Extremely Important Imaging Study

This article is why you may have seen me use the hashtag wrinkles on the inside. There is so much good information in this article to help us educate our patients and to help our patients avoid catastrophizing. There are so many important studies cited in this article that make us think about how we evaluate patients to maximize their outcome. But the real gem of the article is reminding us that imaging is not the end all be all. It is a tool but do not discount your examination. We can’t take pictures of pain. But we can assess how pain responds to movement patterns.
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I highly encourage you to read this article no matter the field of physical therapy in which you work. It will greatly benefit your practice and your patients.

​Jason

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