Back Pain is a widespread and often debilitating condition affecting an estimated 4 million Australians (16.4% of the population) 1, with approximately 70-90% of the population suffering from lower back pain at some point in their life2.
Back pain is also one of the most frequently seen conditions in general practice. A research study conducted in 2015-16 revealed that out of every 100 GP-patient appointments for chronic conditions, 3.1 were related to the treatment and management of back problems. This represents a notable increase compared to the 2.6% incidence recorded in 2006-073.
Many cases of acute back pain can resolve on their own with conservative treatments such as rest, physical therapy, and pain medications. Imaging is typically recommended when there are red flags indicating a potentially serious underlying condition, or when conservative treatments have not been effective.
Imaging Modalities & Intervention
There are several imaging modalities commonly used to evaluate back pain, depending on the patient and pain presentation.
Magnetic Resonance Imaging (MRI) provides excellent visualisation of soft tissue, including intervertebral discs, nerves, and ligaments. This imaging technique is especially useful in detecting herniated discs, spinal stenosis, infections, tumours, or spinal cord compression. By precisely identifying the location and extent of abnormalities, MRI aids in formulating accurate treatment plans.
Computed Tomography (CT) is particularly beneficial in assessing bone structures and detecting bony abnormalities such as fractures or tumours. It can also help identify spinal stenosis and any specific areas which may require further investigation. CT provides greater bone detail compared to x-rays but is less effective in the evaluation of soft tissue compared to MRI.
X-rays provide a high resolution two-dimensional image of the spine. They can be useful in identifying fractures or structural abnormalities such as degenerative changes in the spine, malalignments, and narrowing of the spinal canal. X-rays have limitations in visualising soft tissue such as discs or nerves; MRI is the preferred modality to capture this level of detail.
A number of interventional procedures exist to help relieve back pain depending on diagnosis, medical history, underlying cause, and severity of the pain. A comprehensive evaluation of your patient is necessary to determine the most appropriate intervention.
Imaging Associates offers a range of spinal interventional procedures such as epidural, nerve root and facet joint steroid injections as well as radiofrequency denervation. Our team of sub-specialised radiologists are always available to discuss and determine the most suitable treatment pathways for your patients. We believe in a collaborative approach that combines clinical expertise with advanced imaging techniques to deliver optimal outcomes.
Additionally, imaging alone does not always correlate with the presence or severity of back pain. Many individuals may have abnormal imaging findings without experiencing any pain, and vice versa. Therefore, the interpretation of imaging results should be done in conjunction with a thorough clinical evaluation by a healthcare professional.
Ultimately, the decision to use imaging for back pain should be made by a healthcare professional based on individual circumstances and clinical judgement.
Back Pain Webinar – July 26
To coincide with National Pain Week, Imaging Associates is hosting a RACGP accredited webinar entitled ‘An MRI Imaging Approach to Back Pain’, as part of the Imaging Associates 2023 Education Series.
Presented by MSK Radiologist and Camberwell Clinical Director, Dr Sam Wong, the event aims to provide valuable insights into the role of MRI imaging when diagnosing and managing back pain. The webinar is being held at 7pm on Wednesday July 26, and will qualify for 1 CPD hour.
If you are a medical professional interested in this event, as well as future Imaging Associates Education Series events, click here to register your interest.
References
- Australian Bureau of Statistics. (2017-18). National Health Survey: First results. ABS. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release.
- Australian Institute of Health and Welfare. (2019). Back problems. Cat. No. PHE 231. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems
- Britt H, Miller GC, Bayram C, Henderson J, Valenti L, Harrison C et al. (2016). A decade of Australian General Practice Activity 2006–07 to 2015–16. General Practice Series no. 341, 50-64
