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Studies Frequent X-rays in back pain Much too early and unnecessary
Back pain has become a true folk disease. Every fifth insured person goes to the doctor at least once a year for such complaints. As a new study now shows, X-rays are often taken there, which would not be necessary. Therefore, most pictures do not improve diagnosis or treatment of back pain.
Many x-rays could be avoided
The number of people who need to be treated for back pain continues to rise. As recently reported, last year just under 37 million Germans visited a doctor for musculoskeletal or connective tissue disorders. Of the approximately six million images that are taken every year in the case of back pain-related visits to GPs or specialists, many would be avoidable. This is the conclusion of the "Fact Check Back" study by the Bertelsmann Stiftung.
Due to back pain, around six million X-rays are taken each year. But most pictures do not improve diagnosis or treatment of the condition. (Image: Andrey Popov / fotolia.com) One of the most unnecessary treatments
Many doctors first have their back pain patients X-rayed, because finally no bone damage as a possible cause undetected. But many such investigations are often superfluous. Because back pain is not always the cross itself fault.
Roentgen does not help in the first six weeks to improve the diagnosis of back pain, my doctor of the Swiss Society of General Internal Medicine (SGAIM), who recently published a list of the most unnecessary treatments.
Rarely detect specific causes
This is also reflected in the current study by the Bertelsmann Foundation. While more than two out of three (69 percent) believe the doctor finds the exact cause of the pain through X-ray, computed tomography (CT) and magnetic resonance imaging (MRI).
But: "Doctors can determine just a maximum of 15 percent of those affected a specific cause of the pain. So most pictures often do not improve the diagnosis or treatment of back pain, "states a press release.
Excessive visits to the doctor
According to the experts, the wrong expectations are often not corrected by the doctors. As a result, in addition to an excessive number of visits to the doctor, too many pictures are taken. In 2015 alone, physicians initiated over six million X-ray, CT and MRI images of the back.
"Often the findings of the imaging are overrated. This leads to unnecessary further examinations and treatments, to the uncertainty of the patient and can even contribute to the chronification of the symptoms ", said Prof. Dr. med. Jean-Francois Chenot from the University of Greifswald and medical expert for the fact check.
85 percent of back pain uncomplicated
In addition, the diagnostic imaging is often premature. According to this, every second affected person was given a picture without first having made a conservative therapy attempt, for example with painkillers or physiotherapy. But "85 percent of acute back pain is considered medically uncomplicated and not specific," says the foundation.
As back problems are usually muscular in most cases, it is usually advised to preventively strengthen the back by movement. If symptoms have set in, special back pain exercises or heat therapy can help. Other tips against back pain: avoid overweight or reduce it if necessary and do sports regularly.
Guidelines recommend physical activities
According to the Bertelsmann Foundation, medical guidelines for back pain, with no evidence of dangerous conditions (such as vertebral fractures or inflammation), recommend that you maintain as much physical activity as possible, avoid bed rest, and not perform diagnostic imaging. Doctors often deviate from these scientific recommendations.
Thus, 43 percent of those affected are recommended rest and protection. In addition, physicians often strengthen the feeling of illness of those affected instead of calming them down. According to this, 47 percent of those affected are told that their backs are "broken" or "worn out".
"Physicians need to correct wrong knowledge and expectations of patients. Only then will they live up to their own claim as trustworthy experts, "explained Brigitte Mohn, Member of the Bertelsmann Stiftung Executive Board.
In Berlin and Bavaria back patients go to the doctor more often
In the study, for which the Institute for Applied Health Research evaluated the anonymised data of seven million persons covered by statutory health insurance, there were clear regional differences.
According to the data, patients with back pain in Berlin or Bavaria are much more likely to go to the doctor than in Hamburg, Schleswig-Holstein and Rhineland-Palatinate. The number of treatment cases per 1,000 insured persons and year varies between 370 in Hamburg and 509 in Berlin at federal state level.
It was also found that the regulations of X-ray, CT and MRI scans vary by up to 30 percent between the federal states. In some cities and counties even twice as many pictures are taken as elsewhere.
Talks need to be paid better
"The thorough physical examination and the personal conversation between doctor and patient must regain more weight," said Mohn. This requires corrections in the medical compensation system. Talks would have to be better paid in relation to technology-based examinations.
There are also international examples showing that there are ways to reduce unnecessary and, in case of doubt, unhealthy recordings. For example, physicians in parts of Canada have not been remunerated since 2012 if it turns out that imaging was initiated, even though there was no evidence of a dangerous course of back pain. And in the Netherlands, there are stricter access restrictions to X-ray, CT and MRI devices. (Ad)