Choosing Wisely:

Don’t initially obtain x-rays for injured workers with acute non-specific low back pain.

Rationale and Comments: X-ray is unnecessary for the initial routine management of low back pain unless red flags are present. Even when red flags are suspected, it should not be mandatory to order an x-ray in all cases. There is also no reason, either medically or legally, to obtain low back x-rays as a “baseline” for work-related injuries.
Sponsoring Organizations:
  • American College of Occupational and Environmental Medicine
  • Sources:
  • American College of Occupational and Environmental Medicine guidelines
  • Disciplines:
  • Orthopedic
  • References: • Talmage J, Belcourt R, Galper J, et al. Low back disorders. In: Hegmann K, ed. Occupational Medicine Practice Guidelines. 3rd ed. Elk Grove Village, Ill: American College of Occupational and Environmental Medicine; 2011. p. 336, 373, 376–7.

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