Imaging tests improve the outcome of back pain treatment

Back pain is one of the most common pain conditions and one of the leading causes of work disability. Effective treatment is hard to come by because there are many potential causes of pain, most of which are difficult to diagnose.

A common diagnostic method for chronic back pain is magnetic resonance imaging (MRI). Research in recent years has cast doubt on the usefulness of this type of test in properly diagnosing the cause of pain, as it can falsely identify “abnormalities” in the spine as the cause of pain when the abnormalities themselves are asymptomatic. There is growing opposition in the medical community to the use of this diagnostic method for back pain without neurological symptoms.

Unnecessary tests add to medical bills to no avail. However, the problem with MRIs should not mean that all imaginary tests for back pain are questioned. Research has found that a type of test called single photon emission computed tomography (SPECT) may be a more reliable tool to guide the course of treatment.

The proof

The SPECT imaging test involves the injection of a radioactive substance into a patient’s body. It gives medical professionals a detailed view of what is happening in your back, including how blood is flowing and sites of inflammation. The test is more promising than a basic bone scan, MRI, or X-ray in identifying stealth causes of pain.

Currently, SPECT is used primarily to analyze and diagnose problems in the brain, heart, and bones. With evidence of its usefulness in diagnosing increased back pain, it will one day soon move to this area as well.

Researchers recently evaluated the impacts of SPECT imaging in conjunction with basic computed tomography (CT) on patient outcomes compared to a control group that received no imaging tests prior to treatment. Forty adults were in each group. Many more members in the imaging test group achieved at least a 50% reduction in pain than the control group. Twenty-eight who received scans achieved between 70% and 100% pain relief, compared with just 10 in the control group. Imaging tests altered the diagnosis of 23 of the patients in the bone scan group. These results suggest that the test may lead to more effective treatment. Learn more about the study at http://www.sciencedaily.com/releases/2014/06/140609140814.htm.

This is not the only evidence to support the use of SPECT as part of the diagnosis of back pain. For example, a 2006 study found that imaging helped prevent unnecessary facet joint injections and led to more effective treatment. See more about this at http://interactive.snm.org/index.cfm?PageID=4825.

Effective treatment begins with an accurate diagnosis, and SPECT imaging can help some patients achieve both. If more research confirms its usefulness, SPECT may become a more standard assured diagnostic test for patients with back pain.