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Quality Insights: Clinical Quality in Primary Care

Adult Diagnostic and Preventive Care:
Using Imaging Tests for Lower Back Pain Only When Appropriate

Healthcare quality measure: This measure looks at the percent of adult patients (18 to 50 years old) who get imaging tests within 28 days after being diagnosed with lower back pain. Imaging tests include X-rays, MRIs, and CT-scans. A higher score means that more patients did not get imaging tests during this time – which is good.

Reasons for this measure: Back problems are very common. In fact, 2 in 3 adults in the U.S. have back pain sometime in their lives. It is one of the top ten reasons that people go to see their doctor, and is the most common and expensive reason for going on work disability in the US. Studies show that most patients with lower back pain get better without a lot of medical treatment. Imaging tests, surgery, or other costly treatments often do not help “short-term” back pain (that goes away within four weeks).

Click on a column heading to put the results below in order.
Medical Group	Comparison	Rate	Rating
Benchmarks:    Nat'l Average    90th Percentile    MA Rate		74.2% 82.0% 78.4%
Tufts Medical Center Physicians - NEQCA Go to Group's Website		75.2%
Click on a medical group to view all measures	MA Rate (78.4%)

Select another measure: Colorectal Cancer Screening Tests (Ages 50 to 75) Using Imaging Tests for Lower Back Pain Only When Appropriate Spirometry Test for COPD (Chronic Obstructive Pulmonary Disease) Depression: Short-term Medication Depression: Long-term Medication Yearly Follow-up to Monitor Patients on Long-Term ACE Inhibitors or ARBs Yearly Follow-up to Monitor Patients on Long-Term Anticonvulsant Medication Yearly Follow-up to Monitor Patients on Long-Term Diuretics Yearly Follow-up to Monitor Patients on Long-Term Medication Asthma Care: Medications for Children (Ages 5 to 11) Asthma Care: Medications for Adults (Ages 12 to 50) Cholesterol Screening Test for Cardiovascular Disease Diabetes Care for Adults: Cholesterol (LDL-C) Screening Test Diabetes Care for Adults: HbA1c Test Diabetes Care for Adults: Tests to Monitor Kidney Disease Well-Child Visits: Well Visits for Children 0 to 15 Months of Age Well-Child Visits: Well Visits for Children Ages 3 to 6 Well-Child Visits: Well Visits for Adolescents Ages 12 to 21 Pediatric Medications and Testing: Follow-up with Children Starting Medication for ADHD Pediatric Medications and Testing: Correct Testing for Strep Throat (Pharyngitis) Pediatric Medications and Testing: Correct Antibiotic Use for Upper Respiratory Infections Women's Health: Breast Cancer Screening (Ages 40 to 69) Women's Health: Cervical Cancer Screening (Ages 21 to 64) Women's Health: Chlamydia Screening (Ages 16 to 20) Women's Health: Chlamydia Screening (Ages 21 to 24)

Ways your doctor can help...

• Assess your pain. Your doctor may do an exam of your lower back to find out why you are having this pain. He or she may ask if you have had back pain before and, if so, what helped. Your doctor may ask questions to find out if your back pain is related to another health concern (such as a recent trauma or unexplained high fever) and may order X-rays at this point.
• Suggest ways to help manage your pain. This may include ice, mild pain medication (such as Ibuprofen, the generic version of Motrin or Advil; or Acetaminophen, the generic version of Tylenol), rest, and mild activity such as walking. Most people feel better when they manage their pain with these methods.
• Order imaging tests only if your lower back pain is long-term (lasts four weeks or more). An X-ray, MRI, or CT-scan at that time may help your doctor figure out the cause of your pain and ways to treat it.

Ways you can help...

• Do what your doctor suggests to manage back pain. This may include ice, mild pain medication (such as Ibuprofen, the generic version of Motrin or Advil; or Acetaminophen, the generic version of Tylenol), and rest.
• Be active and move as much as you can. Studies show that this often helps reduce back pain and stiffness.
• Eat a healthy diet. This includes foods with calcium and vitamin D (such as yogurt and other dairy products, and calcium rich vegetables like broccoli). A healthy diet can help keep bones strong and prevent osteoporosis (a disease that weakens bones which may lead to fractures and pain).
• Stay a healthy weight. There is extra stress and strain on your back when you are over-weight. Talk with your doctor about whether you need to lose weight and ask about safe exercise choices.

Ways to learn more...

• American Academy of Family Physicians: Acute Low Back Pain
• Medline Plus Medical Encyclopedia: Back Pain-Low
• The Mayo Clinic: Back Pain

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