{"id":2957,"date":"2025-08-01T01:00:07","date_gmt":"2025-08-01T05:00:07","guid":{"rendered":"https:\/\/www.ncqa.org\/?page_id=2957"},"modified":"2026-01-30T07:37:47","modified_gmt":"2026-01-30T12:37:47","slug":"use-of-imaging-studies-for-low-back-pain-lbp","status":"publish","type":"page","link":"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/","title":{"rendered":"Use of Imaging Studies for Low Back Pain (LBP)"},"content":{"rendered":"<p><span class=\"TextRun SCXW205779705 BCX4\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW205779705 BCX4\">The percentage of persons 18\u201375 years of age with a principal diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within <\/span><span class=\"NormalTextRun SCXW205779705 BCX4\">28 days<\/span><span class=\"NormalTextRun SCXW205779705 BCX4\"> of the diagnosis.<\/span><\/span><span class=\"EOP SCXW205779705 BCX4\" data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2>Why It Matters?<\/h2>\n<p><span data-contrast=\"none\">Approximately 4.3 million ED visits in the U.S. each year are due to a low back pain-related disorder<sup><a href=\"#ref-1\">1<\/a><\/sup>. An estimated 75%\u201385% of all Americans will experience back pain at some point in their lives, and approximately 39% of American adults will experience at least one day of back pain during any three-month period<sup><a href=\"#ref-2\">2<\/a> <a href=\"#ref-3\">3<\/a><\/sup>.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Choosing Wisely, an initiative of the American Board of Internal Medicine Foundation in collaboration with more than 70 specialty society partners, promotes a \u201cnational dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures\u201d by publishing recommendations from the specialty societies to, \u201cfacilitate wise decisions about the most appropriate care based on a patient\u2019s individual situation.\u201d Nine specialty societies have published recommendations regarding the use of imaging for patients with low back pain<sup><a href=\"#ref-4\">4<\/a><\/sup>, indicating the topic\u2019s importance to health care providers.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">Clinical guidelines for treating patients with acute low back pain strongly recommend against the use of imaging in the absence of \u201cred flags\u201d (i.e., indications of a serious underlying pathology such as a fracture or tumor)<sup><a href=\"#ref-4\">4<\/a><\/sup>. Routine imaging is problematic because it is not associated with improved outcomes and exposes patients to harms such as radiation exposure and unnecessary treatment<sup><a href=\"#ref-5\">5<\/a><\/sup>. Red flag conditions include history of cancer, osteoporosis and IV drug use.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"none\">There is no compelling evidence to justify substantial deviation from the diagnostic strategy published in clinical guidelines, which indicate that for most patients with low back pain, diagnostic imaging is usually unnecessary. Although patients may have a perceived need for imaging studies, efforts to educate patients on appropriate indications for imaging are within a provider\u2019s capacity. Organizations can provide information, best-care practice models and other support to providers, imaging centers and members to increase knowledge and ensure that imaging studies are used appropriately for evaluation of lower back pain patients, based on the duration of symptoms and the presence of red flags.<\/span><span data-ccp-props=\"{&quot;134233117&quot;:false,&quot;134233118&quot;:false,&quot;335559738&quot;:240,&quot;335559739&quot;:240}\">\u00a0<\/span><\/p>\n<h2><span data-teams=\"true\">Historical Results \u2013 National Averages<\/span><\/h2>\n","protected":false},"excerpt":{"rendered":"<p>The percentage of persons 18\u201375 years of age with a principal diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of the diagnosis.\u00a0 Why It Matters? Approximately 4.3 million ED visits in the U.S. each year are due to a low back pain-related disorder1. [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":733,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-2957","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Use of Imaging Studies for Low Back Pain (LBP) - NCQA<\/title>\n<meta name=\"description\" content=\"Assesses adults 18\u201350 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Use of Imaging Studies for Low Back Pain (LBP) - NCQA\" \/>\n<meta property=\"og:description\" content=\"Assesses adults 18\u201350 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/\" \/>\n<meta property=\"og:site_name\" content=\"NCQA\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/NCQA.org\" \/>\n<meta property=\"article:modified_time\" content=\"2026-01-30T12:37:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ncqa.org\/wp-content\/uploads\/2021\/04\/NCQA_cmyk_tag.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"627\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NCQA\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/\",\"url\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/\",\"name\":\"Use of Imaging Studies for Low Back Pain (LBP) - NCQA\",\"isPartOf\":{\"@id\":\"https:\/\/www.ncqa.org\/#website\"},\"datePublished\":\"2025-08-01T05:00:07+00:00\",\"dateModified\":\"2026-01-30T12:37:47+00:00\",\"description\":\"Assesses adults 18\u201350 with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI or CT scan) within 28 days of the diagnosis (a higher score indicates better performance).\",\"breadcrumb\":{\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/use-of-imaging-studies-for-low-back-pain-lbp\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.ncqa.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Report Cards\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Health Plans\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"State of Health Care Quality Report\",\"item\":\"https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/\"},{\"@type\":\"ListItem\",\"position\":5,\"name\":\"Use of Imaging Studies for Low Back Pain (LBP)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.ncqa.org\/#website\",\"url\":\"https:\/\/www.ncqa.org\/\",\"name\":\"NCQA\",\"description\":\"Measuring quality. 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