DO GENERAL PRACTITIONERS STILL ORDER LUMBAR SPINE X-RAYS IN BACK PAIN FOR PSYCHOSOCIAL REASONS

Purpose of study A recent audit in our institution showed that 40% of Lumbar spine X-rays ordered by General Practitioners were outside the Royal College of Radiology guidelines. Little in 1998 had commented that GPs requested Lumber Spine X-rays for psychosocial reasons. Methods An online survey was conducted on www.surveymonkey.com among the local GPs to determine their practice and preferences in investigating low back pain. The 5 questions in the survey were “rating scale questions” on a scale of 1 and 10, where 1 = DISAgree and 10 = Agree. A request to participate in the survey was sent to all the local General Practitioners by e-mail. Results 36 General Practitioners participated in the survey. Participants agreed that if there were no red flags and no significant neurological deficit they were satisfied in not requesting further investigations (6.03/10). They did not feel the need to order investigation just to reassure an anxious patient (5.31). In day to day practice they however were forced to request X-rays (6.72) though they preferred to request MRI scans (7.55). They also felt frustrated that MRI scans could not be directly ordered by GPs (6.69). Conclusion This limited study demonstrates that General Practitioners “Do not investigate back pain just to reassure the patient but are frustrated that they are not able to directly request MRI scans for their patients. Increased efforts to educate the public and health professionals that a negative X-ray result of the lumbar spine is not reassuring should be matched by easy access to MRI scans.