In 2012, the American Board of Internal Medicine Foundation launched Choosing Wisely®. The program aims to help people make better choices about their care.

Choosing Wisely urges doctors and patients to talk about care options so that patients can choose care that is needed and safe. As part of this program, more than 50,000 doctors put together a list of treatments and procedures that are sometimes overused. 

In all the lists, there’s no single test, treatment or procedure that is always “wrong.” The lists are meant to help doctors give the right care at the right time and help people become smarter health care users. 

Choosing Wisely can help you make smart choices about many health issues, including low back pain.

Most of us have had low back pain at some point in our lives. According the National Institutes of Health, in a three-month time, about 25 percent of adults will have at least one day of back pain.*

Most instances of back pain go away with little need for medical care. Other times, back pain can limit our daily activities, so a visit to the doctor is needed. Pain medications and special exercises for the back are often prescribed. You might be surprised to learn that you probably do not need an X-ray, CT scan or MRI.

X-rays, CT scans and MRIs, also called imaging tests, show pictures of the inside of your body. While imaging tests do give plenty of data, they are often not helpful for finding the cause of low back pain.

In addition, getting an imaging test will not take away your pain or shorten the time you need to get better. And sometimes imaging tests can lead to other procedures, like surgery, that you don’t need.

It is easy to get imaging tests, but they are not without risk. X-rays and CT scans use radiation to take their pictures. Being exposed to radiation over time can raise your risk of cancer, so it’s best to limit them. Imaging tests can also be expensive. Costs can range from hundreds of dollars for X-rays up to thousands of dollars for an MRI. 

There are times when getting an imaging test makes sense. If you have low back pain and any of these symptoms, talk to your doctor right away:

  • Fever over 102° F
  • Loss of control of your bowel or bladder
  • Loss of feeling or strength in your legs
  • Problems with your reflexes
  • A history of cancer
  • Weight loss that you cannot explain

These can be signs of a serious problem like nerve damage, infection or cancer.

For more information about the Choosing Wisely project, visit