Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians

Ann Intern Med. 2011 Feb 1;154(3):181-9. doi: 10.7326/0003-4819-154-3-201102010-00008.


Diagnostic imaging is indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. In other patients, evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms. Addressing inefficiencies in diagnostic testing could minimize potential harms to patients and have a large effect on use of resources by reducing both direct and downstream costs. In this area, more testing does not equate to better care. Implementing a selective approach to low back imaging, as suggested by the American College of Physicians and American Pain Society guideline on low back pain, would provide better care to patients, improve outcomes, and reduce costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnostic Imaging / economics*
  • Diagnostic Imaging / statistics & numerical data*
  • Evidence-Based Medicine
  • Guideline Adherence
  • Health Care Costs*
  • Humans
  • Low Back Pain / diagnosis*
  • Low Back Pain / economics
  • Magnetic Resonance Imaging / economics
  • Magnetic Resonance Imaging / statistics & numerical data
  • Practice Guidelines as Topic
  • Radiography / economics
  • Radiography / statistics & numerical data
  • Tomography, X-Ray Computed / economics
  • Tomography, X-Ray Computed / statistics & numerical data
  • Treatment Outcome
  • Unnecessary Procedures*