We are back with our “2 for Tuesday” series on Back Talking! I am hosting weekly Facebook Live sessions every Tuesday at 2 pm, so check us out over on Facebook at The Joint Morrisville page. This week was our first show on Facebook live, so the first question that I answered was an easy one – Who am I, and why you should listen to me. The second question was asked of me in the office last week, someone was surprised to find out that x-rays weren’t necessary. So question 2 is “Are x-rays necessary?”
Are X-rays Necessary?
There are many tools that doctors have in their toolbox, and imaging studies such as x-ray, CT scans, and MRI allow us to peer into the body like never before. But in my opinion, the most important part of a patient encounter is the history. If the doctor asks the right questions, they have in their mind a working diagnoses before they have even touched the patient. In the answers that the patient is giving the doctor, they are listening to what are termed red flags. These are items that get the doctors attention and require further investigation.
In regards to x-rays for back pain, they are only indicated if one or more of the following red flags are present:
- severe or progressive neurologic deficits such as loss of motor control ( i.e. foot drop or loss of reflex upon exam)
- loss of bowel or bladder control
- unexplained weight loss
- previous history of cancer
- long term use of steroids or immunosuppressants
So the answer to the question “are x-rays necessary?” is occasionally. Thank goodness that these red flags are not very common. In my practice maybe less than 5% of first time patients are referred out for some type of imaging.
To listen to the podcast, click on the link below.