Mar 27th 2018

Conservative Care: Treating Lower Back Pain

​Primary care physician visits for lower back pain (LBP) have increased over recent years, and LBP continues to be one of the top five reasons to see your doctor. Many physician groups have provided clinical practice guidelines that offer direction on how to make smarter choices with respect to LBP and advanced imaging procedures such CT scans and MRIs. eviCore incorporates these evidence-based guidelines into its own determinations in order to ensure its client's patients receive the best care.

Well-established research has shown that patients who received advanced imaging before trying more conservative care, such as physical therapy, incurred higher costs by an average of $4800. Moreover, the findings in imaging—such as disc degeneration, arthritis, bulging discs, etc.—may not identify the actual cause of your pain.

As a matter of fact, if you are age 30 or older your imaging may show all of the above, but you might not have any back pain limiting your function. Yet now that you and your doctor know that those ugly-sounding conditions are there, pressure is exerted on your physician (and yourself) to do something about those imaging findings … and that leads to more procedures and higher costs.

The emerging research and data show very strongly that conservative choices, especially physical therapy, should be the first choice. A 2013 JAMA study examining 440 million visits for LBP over a 10-year period revealed: