Six trials (n = 1804) were included, of which five met four or more quality criteria.
There was no significant difference between the imaging and usual care groups for pain or function at either short-term (SMD 0.19, 95% confidence interval (CI): -0.01, 0.39 for pain and 0.11, 95% CI: -0.29, 0.5 for function) or long-term (SMD -0.04, 95% CI: -0.15, 0.07 for pain and 0.01, 95% CI: -0.17, 0.19 for function) follow-up. Statistical heterogeneity was significant for short-term changes in function (I2 72%, p = 0.03).
Trial quality, use of different imaging methods and duration of low-back pain did not affect the results. Results for other outcomes also did not differ between groups.