Low back pain and x-ray films of the lumbar spine: a prospective study in primary care.
We prospectively studied 96 men with low back pain to evaluate the association of x-ray findings with clinical diagnosis, treatment, functional outcome, and satisfaction with care. Degenerative joint disease (DJD) was the most common radiologic finding (70%). Making the diagnosis of spinal DJD has little effect on patient management, but patients with x-ray evidence of DJD were three times more likely than those with normal films to receive nonsteroidal anti-inflammatory drugs other than aspirin. Furthermore, patients given a "diagnostic label" of DJD were more likely to express satisfaction with medical care and less likely to seek care elsewhere than patients with similar x-ray results who were given nonspecific diagnoses. These factors will need to be considered in arriving at an estimate of the net benefits of x-ray examination of the lumbar spine.
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001416:Back Pain / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D003258:Consumer Behavior; D004359:Drug Therapy, Combination; D005069:Evaluation Studies as Topic; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D011320:Primary Health Care / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D009125:Muscle Relaxants, Central