Necessity of Radiography in Young Adults presenting with Low Back Pain of Short Duration

Background and Objectives: The occurrence of low back pain of short duration and without positive clinical findings is high. 15% and 30% of the population suffer from this condition. Young working adults are most commonly affected by this condition. Aim of this study is to assess the necessity of plain radiography of lumbosacral spine in diagnosing and treating young patients presenting in Orthopaedic outpatient department with low back pain of short duration without history of trauma and no positive clinical findings. Methods: We prospectively studied 500 young patients of age between 25 to 40 years presenting with low back pain of less than 3 months duration without any history of trauma and no positive clinical finding. We excluded patients with history of trauma, fever, patients with radiating pain, neurodeficit, Patients with bladder/bowel complaints and Patients with any other systemic disorder. All these patients received standard treatment in the form of short term medication, postural training and application of ergonomic principles while working. Results: 64% of the patients recovered fully within 2 weeks of treatment. 36% of the patients were not relieved hence Lumbosacral spine radiographs were performed after 2 weeks of treatment. Positive findings on radiographs were early degenerative changes and loss of lumbar lordosis due to para-spinal muscle spasm, seen in 9.7%of the patients in whom radiographs were performed. These radiographic changes were not indicative of different modality of treatment, hence we continued the same treatment and further31% of the patients were recovered fully after 4 weeks of treatment. Interpretation and Conclusions: Performing lumbo-sacral radiographs does not have any influence on treatment or outcome in young patients presenting with low back pain of less than 3 months duration without any history of trauma and no positive clinical finding. Key words: Low back pain, Lumbosacral spine radiograph