Radiologist-developed Guidelines Help Low Back Pain Workup

Radiologists have developed evidence-based guidelines to help physicians manage patients with low back pain in an attempt to reduce inappropriate imaging and invasive procedures.

"We have presented a logical method of choosing, developing and implementing clinical decision support interventions that is based on the best available evidence,” said Scott E. Forseen, MD, a co-author of the article published in the October issue of the Journal of the American College of Radiology. “These templates may be reasonably expected to improve patient care, decrease inappropriate imaging utilization, reduce the inappropriate use of steroids and narcotics, and potentially decrease the number of inappropriate invasive procedures."

Radiologists from Emory University Hospital in Atlanta and Georgia Health Sciences University in August, Ga., developed a system whereby patients who present with low back are initially categorized into one of three groups:

• Non-specific low back pain;

• Low back pain potentially associated with radiculopathy or spinal stenosis; or

• Spinal stenosis or low back pain potentially associated with a specific cause.

The radiologists then applied a set of templates that they had devised for each group that would act as a guide for evaluation, management, and follow-up of the patients. Forseen said physicians’ workup and management of low back pain is inconsistent, and there is variability among and between specialties.