Costly diagnostic MRIs unnecessary for many back pain patients

By Stephanie Desmon, Johns Hopkins Medicine

Johns Hopkins–led research suggests that routine MRI imaging does nothing to improve the treatment of patients who need injections of steroids into their spinal columns to relieve pain. Moreover, MRI plays only a small role in a doctor’s decision to give these epidural steroid injections, or ESIs, the most common procedure performed at pain clinics in the United States.

With greater focus on runaway health care costs, the study’s findings, appearing online in the Archives of Internal Medicine, highlight one element of the problem: the indiscriminate use of an expensive imaging tool that shows little clinical benefit.

“Our results suggest that MRI is unlikely to avert a procedure, diminish complications or improve outcomes,” said study leader Steven P. Cohen, an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “Considering how frequently these epidural injections are performed, not routinely ordering an MRI before giving one may save significant time and resources.

“If we’re trying to cut back on unnecessary medical costs,” Cohen added, “we should stop routinely doing MRIs on almost everyone who comes to us needing ESIs.” A single MRI costs roughly $1,500.

source: Johns Hopkins University