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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?

Design

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

Setting

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

Patients

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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