Psychosocial consequences of diagnosing nonspecific low-back pain radiologically: a qualitative study

Background: Chronic low back pain (CLBP) is a complex biopsychosocial problem with financial implications for society. Most LBP is categorized as nonspecific CLBP (NS-CLBP); magnetic resonance imaging (MRI) is increasingly used in the investigation of LBP but has a high false-positive rate for NS-CLBP. Purpose: To explore the psychosocial factors associated with diagnosing NS-CLBP by MRI in Saudi Arabia. Methods: Using a qualitative design, 11 patients with CLBP without a clear medical diagnosis who had received an MRI scan were interviewed using a semi-structured technique, and transcripts were analyzed using framework analysis. Results: Four themes of relevance to the psychosocial consequences of using MRI to diagnose CLBP were identified: 1) impact on social participation after MRI diagnosis; 2) psychological impact of MRI diagnosis; 3) conflicting advice; and 4) patient education. Although some patients expressed a sense of relief following the identification of an objective explanation of their symptoms by MRI, a number of negative consequences were also identified. In particular, fear-avoidance behavior and anxiety were apparent. Conclusion: The use of MRI scanning in the diagnosis of LBP may lead to psychosocial factors influencing participation in physical and social daily activities.