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����Medical experts hoped that improved diagnostic imaging instrumentation�� such as computed tomographic ��CT�� scanning and magnetic resonance imaging ��MRI���� would make possible more precise diagnoses for most backpain patients. This promise has been illusory. One important reason is that�� as in the x-ray studies�� alarming abnormalities are found in pain-free people.����Findings from various studies suggest that many red herrings confuse imaging interpretation'and that at least for some�� spine abnormalities are purely coincidental and do not cause pain. Moreover�� even the best imaging tests fail to identify the simple muscle spasm or injured ligament probably responsible for pain in a substantial percentage of back patients. All this imaging perplexity caused one orthopedic surgeon to remark�� "A diagnosis based on MRI in the absence of objective clinical findings may not be the cause of a patient's pain�� and an attempt at operative correction could be the first step toward disaster." In other words�� the office examination is at least as important as the imaging test�� and surgery for patients whose back pain is associated only with abnormal imaging results can be unnecessary if not down- right detrimental. Many physicians now advocate CT scans and MRI only for those patients who are already surgical candidates for other reasons.����Complicating the situation still further is the fact that most patients with acute low-back pain simply get better - and quickly. A study comparing treatment outcomes found no differences in functional recovery times among patients who saw chiropractors�� family doctors or orthopedic surgeons. Cost�� on the other hand�� varied substantially�� with family doctors costing least and surgeons most. The Hippocratic admonition "First�� do no harm" may be the most important counsel with regard to this condition - the favorable natural history of acute low-back pain is hard to beat.��������