The pain may be real, but the scan is deceiving.  In the 12/9/2008 New York Times series entitled The Evidence Gap, Gina Kolata writes that "... patients who are in pain often demand scans hoping to find out what is wrong, doctors are tempted to offer scans to those patients, and hten, once a scan is done, it is common for doctors and patients to assume that any abnormalities found are the reason for the pain.  As many as 60% of healthy adults with no back pain have degenerative changes in their spines.  Scans -- more sensitive and easily available than ever -- are increasingly finding abnormalities that may not be the cause of the problem for which they are blamed." 

Importance of physical exam cannot be underestimated. In the 2/12/2009 New York Times Doctor and Patient Column, Pauline W. Chen, MD, wrote about an interview with "Dr. Abraham Verghese, the critically acclaimed author of two nonfiction books and a professor of medicine at Stanford University" on "the importance of the physical exam, or what he refers to as 'bedside skills,' in modern medical practice." He noted that physicians "order a lot of tests" thinking they "are saving time or because [they] are uncertain." But, spending "more time listening to a patient or being more thoughtful" will "end up saving time," Dr. Verghese argued. And, in spite of "the limitations of the physical exam," he stated that it "is an important ritual whose" significance "has diminished for doctors because we have other ways of getting information."

Experts question effectiveness of surgery for back pain. The 1/9/2009 Los Angeles Times reported, "An aching back -- a dull twinge or a stabbing pain, lasting days or years -- is a source of annoyance, misery, or even disability for millions of sufferers." In fact, "80 percent of the population will experience back pain at some point in their lives, and while the majority of cases resolve quickly, 30 percent recur, according to the North American Spine Society." The group also estimates that Americans spend over "$80 billion" annually on treatments for back pain. But, some experts say that "expensive treatments and surgeries...may not help patients much." They even "argue that doctors need to think more before they resort to the knife," and "note that the US has, by far, the highest frequency of back surgeries among developed nations: There are approximately 1.2 million spinal surgeries in the US each year, double the rate in those other countries."