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Early Imaging Doesn't Improve Back Pain Outcomes in Seniors

For older adults with new primary care visit for back pain, no improvement with early imaging

TUESDAY, March 17, 2015 (HealthDay News) -- Early imaging is not associated with improved outcomes at one year among older adults with a new primary care visit for back pain, according to a study published in the March 17 issue of the Journal of the American Medical Association.

Jeffrey G. Jarvik, M.D., M.P.H., from the University of Washington in Seattle, and colleagues compared pain and function at the 12-month follow-up visit among older adults who received early imaging versus those who did not receive early imaging after a new primary care visit for back pain. Data were included for 5,239 patients aged 65 years or older with a new primary care visit for back pain without radiculopathy. Propensity-score matching was conducted for demographic and clinical characteristics, including diagnosis, pain severity, pain duration, functional status, and prior resource use. Among the cohort, 1,174 patients had early radiographs and 349 had early magnetic resonance imaging/computed tomography (MRI/CT) within six weeks of the index visit.

The researchers observed no significant difference for the early radiograph group or the early MRI/CT group versus controls on the disability questionnaire at 12 months. For patients who underwent early radiograph, the mean score was 8.54, compared with 8.74 for controls (P = 0.36); for the early MRI/CT group, the mean score was 9.81, compared with 10.50 for the control group (P = 0.18).

"Among older adults with a new primary care visit for back pain, early imaging was not associated with better one-year outcomes," the authors write.

Several authors disclosed financial ties to the pharmaceutical, medical device, and medical technology industries.

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