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Radiography led to improved patient satisfaction but increased short term pain in patients with low back pain

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 QUESTION: In primary care patients with low back pain of ≥6 weeks duration, does radiography of the lumbar spine help to improve clinical outcomes or satisfaction with care?


Randomised {allocation concealed*}, unblinded,* controlled trial with 3 months and 9 months follow up.


73 general practices in Nottinghamshire, southern Derbyshire, northern Lincolnshire, and northern Leicestershire, England.


421 patients who were 20–55 years of age (median age 39 y, 59% women) and had had low back pain for ≥6 weeks. Exclusion criteria were chronic back pain (>6 mo duration); radiography of the lumbar spine in the previous year; unexplained weight loss or fever; use of oral steroids; history of malignancy, tuberculosis, injecting drug use, or positive result on HIV test; symptoms or signs of a cauda equina lesion; or pregnancy. Follow up was 95% at …

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  • Source of funding: NHS Research and Development Health Technology Assessment Programme.

  • For correspondence: Dr D Kendrick, Division of General Practice, School of Community Health Sciences, University Park, Nottingham NG7 2RD, UK. Fax +44 (0)115 970 9389.

  • * See glossary.

  • Information provided by author.