Imaging solutions have long since been one of the most trusted ways of determining internal health issues. Be it fever, prolonged and severe headache, or abdominal pains, physicians recommend imaging for the right diagnosis.
Background Of The Study
Low back pain is a common issue these days. It emerges due to several reasons. A long hour sitting work schedule, an old injury, spinal cord problems are many more can be the source of back pains.
However, evidence states that imaging has very little to do with the care and cure of such pains. The international guidelines lay down for back pains strongly suggest not using imaging unless the patient has a record of cancer, infection or any such pathology.
However, in reality, most people undergo imaging when detected with back pain. Even though imaging’s benefit on clinical outcomes is not clear, many people find it satisfactory. As far as the data supports, imaging remains associated with inferior quality patient outcomes, more healthcare utilization, and surged healthcare costs. Low back pain often brings patients to Chiropractic care.
Therapies, advice, spinal manipulation, exercise and more remain integrated with this special care regime. However, studies have failed to unveil any direct and significant relation between imaging and back pain care. The recent study focused on finding the relationship between clinical outcomes of patients suffering from low back pain and imaging.
Methods
The study considered observational data of longitudinal variety with another year’s follow-up inputs related to Denmark’s chiropractic clinics and their primary care segment. The data belonged to the span of 2016 to 2019.
The list of participants had the patients presented to chiropractic care with low back pain. However, patients below the age o 18 years were not a part of the study. Patients with diagnosed pathology conditions were not a part of the study.
Patients who had already done imaging for their present clinical conditions were also not a part of this study. The study considered certain bases like variables such as pain characteristics, participant demographics, and clinical history.
The researchers matched the participants referred to and not referred to diagnostic imaging keeping the baseline variable in mind. The two groups of participants were the exposure group and the non-exposure group. The former group had people who were referred to imaging at their first visit to the chiropractor. The latter group had patients whom the chiropractor did not refer to imaging on their first visit.
The team used logistic regression and mixed linear models to gauge the impact of imaging on the intensity of back pain. The study also focused on the extent of disability consequent upon three weeks, two weeks or one year of back pain.
There were more than two thousand participants involved in the study. The mode of collecting data was through questionnaires. The questionnaires had almost every variety of relevant questions to cover all the areas necessary for interpreting the impact of imaging on back pain.
The Result
Of the 2162 patients who participated, researchers found that 24.1% went for imaging following a referral. The study further found a balance between the matched groups for the underlying variables except for leg pain intensity and age.
Patients who availed of imaging facilities suffered from more intense back pain than the ones who did not have to opt for imaging. The groups did not show differences in any other aspect. When the researchers conducted sensitivity analysis after doing the necessary adjustments for pain intensity and age, they got similar results. The researchers took data after two months, three months and one-year intervals respectively. Each time the outcomes for the two matched groups turned out to be similar. Thus, the extent of disparity between the two groups’ results was negligible.
Final Words
The study covered 2162 participants of whom 874 were women. Their mean age was around 43.3 years. 522 out of them belonged to the exposure group. Of them, 505 had a referral for an X-ray, 8 for an X-ray and MRI, and 7 for only MRI.
There were 2 women whom the chiropractor referred for X-ray, MRI, and CT. this was one side of the picture. The rest of the participants had similar segregation based on different variables. However, the results for all of them turned out to be very similar.
The study clearly showed that diagnostic imaging practices had no direct positive effects on patients suffering from low back pain for a very long time. The data revealed the correlation between existing co-morbidity and back pain intensity.
On the other hand, it did not show any direct relation between imaging and back pain care outcomes. Therefore, the recent guidelines, related to imaging for chiropractic practices stand substantially viable.
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