Imaging studies can exacerbate injury perception

The traditional way of dealing with back pain was to send workers to an MRI scan, which often led to a doctor delivering bad news that surgery might be necessary, said Dr. Matthew Walsworth, a radiologist with West Los Angeles VA Medical Center and faculty member at the University of California, Los Angeles.

Instead, the issues that pop up on an MRI screen can be likened to the “gray hair and wrinkles in the spine,” he said.

Dr. Walsworth participated in a session on back pain at the California Workers’ Compensation and Risk Conference in Dana Point in September. In his presentation, he referred to several case studies, including that of a 62-year-old man with back pain and an imperfect spine.

He said that some doctors would look at such an image and order surgery, which might exacerbate the overall injury and delay recovery.

“This is not a pristine spine, but it (shows) normal changes; if you want to grasp something to operate on, you could,” he said.

Instead, treating physicians can delay an MRI and work toward a recovery solution that could include physical therapy and cognitive behavioral therapy, Dr. Walsworth added.