My wife went to see the doctor for a bad back. All she got was a prescription for muscle relaxers and told to stay active. No X-rays. No CT scans or MRIs. Should she get a second opinion?

With the rising cost of health care, doctors are taking a second look at advanced imaging studies like CT scans or MRIs. Research shows over and over again that imaging studies aren’t that helpful.

Many patients with acute low back pain (LBP) have normal X-rays. In a recent study of 100 LBP patients everyone had a normal X-ray. CT scans were also done. Only six of the patients had clinical symptoms that matched the CT scan for disc bulging. In fact, one-third of the patients with signs of disc problems on the CT scan didn’t have any symptoms of disc problems. And half of the patients who did have disc symptoms didn’t have any sign of a disc problem on the CT scan.

Almost all acute LBP patients get better with the advice your wife’s doctor gave her. Advanced imaging and more aggressive treatment are used when a patient doesn’t get better or gets worse instead.

Best practice right now says to follow the doctor’s advice and see what happens in the next 10 to 14 days. It may mean a few days of back discomfort but it will save your pocketbook from hurting unnecessarily.