Dr. Cho of the Mt Sinai Medical Center in New York looked at over 16,500 medical studies on low back pain. He was trying to determine which ones are cited most often. From the original group, Dr. Cho found 322 papers that had been cited at least 100 times. From this, Dr. Cho tried to divine what are the important trends in medical research on low back pain. The most commonly-cited study (more than 1,000 times) was from 1990. This paper showed that many people have abnormalities that show up on MRI's, but cause no symptoms. Interestingly, the second most cited paper was on the same topic. The third study other researchers cited most was an analytic review of the affect of back pain on patients' lifestyles. The top two most popular papers suggest that MRI's may not be the best diagnostic tool. This could suggest that medical research into lower back pain is focusing on less intervention instead of more. That seems to be inline with the current evolution in thinking about medicine. It should also give pause to anyone who gets an MRI report showing some sort of abnormality. Perhaps more caution is needed before pursuing invasive procedures.