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Do you need X-ray/MRI and exercises?

Lower back X-rays generally unnecessary.

Every year, GPs in the central part of the southern Dutch province of Brabant have about 2000 X-rays done of patients presenting with lower back pain. What is the significance of these X-rays, health insurance companies and the GPs wondered. None, concludes specialist F. Van Buchem, investigator. Orthopedic surgeons en radiologists are of the opinion that such images hardly tell anything about the complaints people with lower back pain experience. Quite often, no indications are found in people suffering complaints and vice versa. Two years ago, the research team of GPs, radiologists and orthopedic surgeons, under the expert guidance of Mr. Van Buchem, started an investigation using this knowledge as a starting point. The GPs participating in the investigation (almost all of them took part) were asked to indicate the reason for requesting an X-ray. They had a choice of ten medical (e.g. GP wants to either demonstrate or rule out a condition) and non-medical reasons (e.g. the patient wants it or the GP wants to reinforce his opinion). By far in most cases, medical reasons were given. Over 65 percent of the X-rays were requested for these reasons. However, non-medical reasons also scored high with almost 20 percent. Ninety percent of the GPs proved to be very satisfied with the outcome of the X-ray, because it met his or her intentions. According to the investigators, this is particularly the case because the GP experiences the outcome as an encouragement in the treatment of the patient, without this strictly being so medically. Non-medically speaking, Van Buchem feels taking lower back X-rays may be a sensible thing to do. "The GP gains more authority towards the patient and can therefore treat more effectively." The investigators further conclude that it is not just medical specialists and GPs who are to blame for high health care costs. Van Buchem: "Costs like these are often incurred because the patient wants it or because the patient cannot accept the fact that the specialist cannot really do anything about his/her complaints."

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