Avoid use of imaging studies for low back pain in first six weeks unless an exclusion applies

In a three-month period, more than one-fourth of U.S. adults experience at least one day of back pain. Recommended treatment guidelines indicate that you shouldn’t do imaging for low back pain within the first six weeks unless an exclusion applies.

Imaging studies done less than six weeks after the onset of low back pain rarely improve outcomes, and they increase medical costs and radiation exposure. Less than 1 percent of imaging identifies a specific cause of low back pain within the first six weeks of the onset of pain.

Exclusions may include, but aren’t limited to, conditions such as history of cancer, recent trauma within the last three months, history of HIV or history of organ transplant.

Managing acute low back pain in the first six months may include:

• Instructing the patient to stay active as tolerated by pain
• Avoiding bed rest
• Doing back exercises
• Injury prevention
• Using of over-the-counter pain relievers

If ordering an imaging study prior to six weeks of the onset of back pain when an exclusion applies, be sure to code the exclusion in addition to the diagnoses of low back pain.