An English group studied[1] the usefulness of Magnetic Resonance Imaging (MRI) in the clinical assessment of Low Back Pain. Although both pain and MRI abnormalities were common, there was no clear relationship between the two. Whereas nearly half the working men studied had abnormal scans, a third of those with MRI abnormalities had no pain (see also Medical Litigation News Volume 2, Issue 4), and nearly half of the men with Low Back Pain had normal scans. For the 10% of subjects who suffered Low Back Pain for the first time during 12 months of follow-up, there were no changes in the MRI which could account for the onset of pain.
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POINT Though a sensitive technique for detecting abnormalities in the Lumbar Spine, MRI usually fails to elucidate causes of Low Back Pain |
A critical review[2] of the effectiveness of various modes of treatment for Low Back Pain found that most of the 40 studies had significant flaws. For acute pain, there was limited evidence for the benefit of little or no bedrest, and for spinal manipulation. For Chronic Low Back Pain, the only intervention with any proof of efficacy was Antidepressant medication.
In an unrelated Dutch study of general practice patients[3], physical therapy appeared to have an adverse effect on the duration of Chronic Low Back Pain.
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POINT Apart from Antidepressant medication no Evidence-Based treatments can be recommended for Chronic Low Back Pain |
Involvement in Compensation was again (Medical Litigation News Volume 2, Issue 10) shown to have an adverse effect on the reporting of pain, depression and disability by Chronic Low Back Pain sufferers[4]. The Compensation effect increased during spine rehabilitation, obliterating any improvement in pain a year into the programme.
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POINT The optimistic prognosis arising fron studies of Low Back Pain treatment outcome does not apply to clients seeking Compensation |
In a similar Irish study[5], quality of life failed to improve in Litigants, despite gains in impairment and disability.