Reference:Raastad J et al The association between lumbar spine radiographic features and low back pain: a systematic review and meta-analysis.Semin Arthritis Rheum. 2015 Apr;44(5):571-85.
I know I have written a lot on the papers showing how common “abnormal” radiological findings are. However, imaging is not always useless.
This latest systematic review concluded that there was a significant, positive association between disc space narrowing and LBP.
They also found a strong association between spondylolisthesis and occupational LBP.
I am still torn with the conclusion of this paper; sure there is an association, now what?? What’s the point in knowing that?
Are we going to surgically fuse all people with DDD or spondylolisthesis?
Association does not mean cause.
Perhaps those who are told they have DDD have more fear, become less active and therefore have persistent LBP when compared to those who happen to not have and not told of severe DDD on their x-rays.
All I can say is that non-red flag radiological findings remain irrelevant to me. As PTs we treat functional movement impairments… who cares what the bones look like?we can?t change it!
Posted on: October 11, 2015
Categories: Fascinating Pain Studies