I agree,
I would not see many X-rays that would change my treatment. X-rays often
give the patient an importance or fear of the term "degenerative" and disc
bulge. As we all know we could pull 100 people randomly off the street and
x-ray them and are likely to find 80% with unsymptomatic disc bulges.
I have often had genuine patients with perfectly normal x-rays and severe
pain and vice versa. 90% of my case load is chronic back pain and they have
often been x-rayed out!
Regards,
Anna Lee
-----Original Message-----
From: Michael Meddows <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Thursday, 31 December 1998 13:32
Subject: Re: x ray-low back
>Regarding Patrick Zerr's question:
>
>>Isn't there also some value to seeing the alignment, disc space and/or
>degenerative
>>changes?
>
>I would think "no". Degenerative changes are the norm in patients typically
>seen in a physio's office, disc space measurements from xrays are not
>reliable as they could be and 'abnormal' disc heights are not specific to
>anything in particular, and I don't know if alignment 'abnormalities' are
of
>much help in planning a rehab programme. Of course there are exceptions
such
>as in trauma, instability, and other cases, where seeing plain films will
>change treatment. (ideally the referral source is already aware, but you
can
>never rely on that to be true)
>
>Most guidelines based on sound research state that x-ray studies should
only
>be ordered if a red flag is present. Maybe there is also a point when an
>xray should be read if a spondylo is suspected.
>
>Can you justify using x-rays for LBP rehab based on anything opther than
>personal experience ( even if it is quite substantial ) ?
>
>>Do you get x-ray reports often? I do.
>
>
>Do they change your treatments? and how/why?
>
>>I typically avoid extension exercises when a spondylo is present.
>
>I think there was an article published regarding this issue recently, does
>anyone recall it?
>
>
>Michael Meddows
>[log in to unmask]
>
>
>
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