; Your Health
3. Antibiotics for mild to
moderate sinus infections.
American Academy of Family
Physicians; American Academy of
Allergy, Asthma & Immunology
Despite physician awareness cam-
paigns about the overuse of antibi-
otics for sinus infections, the drugs
are prescribed in more than 80
percent of these cases. In fact, the
cases account for about 20 percent
of all adult antibiotic prescriptions.
More than 90 percent of sinus in-
fections are caused by viruses—and
the drugs work only against bacte-
Dangers: The overuse of antibiot-
ics can leave you vulnerable to in-
creasingly virulent strains of drug-
Exceptions: If symptoms last for
more than seven days or worsen af-
ter initially improving. If you devel-
op a secondary bacterial infection,
antibiotics may be needed.
pressure, reduce the effectiveness
of blood pressure meds, trigger fluid
retention and impair kidney func-
tion. A recent study looked at older
people on blood pressure meds who
also took NSAIDs. They found twice
as many deaths—mainly from heart
attacks and strokes—among those
regularly using NSAIDs. Tylenol
(acetaminophen), tramadol or short-
term use of narcotic painkillers may
be safer than NSAIDs, according to
Dangers: NSAIDs are linked to
stomach bleeding and increased
risk of heart and kidney problems.
4. NSAID painkillers for
people with high blood
pressure, heart failure and
any chronic kidney disease.
American Society of Nephrology
Many people turn to NSAIDs—Advil
and Motrin (ibuprofen) or prescriptions such as Celebrex and Voltar-en—for pains ranging from arthritis
to headaches. But for those with high
blood pressure or kidney disease,
these medications can raise blood
5. CT scans and other imaging
for uncomplicated headaches.
American College of Radiology
Severe headaches can be excruciating
and frightening, but unless they’re
accompanied by other key symptoms, it rarely makes sense to get a
CT scan or MRI of the brain. And yet
“it happens all the time,” says David
Seidenwurm, M.D., a neuroradiolo-gist in Sacramento, Calif., who helped
craft the recommendation. Patients
get frightened, doctors worry about
lawsuits and people want instant information, he says. “It’s easier to do
the scan than to have the conversation.” Doctors also may misinterpret
a bend in a blood vessel on a test as a
sign of a stroke or aneurysm. Imaging tests have contributed to a nearly
sixfold increase in radiation exposure since the early 1980s. Half of
all exposure to radiation now comes
from medical tests and procedures.
Dangers: Radiation exposure raises
cancer risks in the population, and
false positive results lead to more
testing and patient anxiety.
Exceptions: Trouble speaking,
blurred vision, weakness on one
side or other symptoms may suggest the headache is a sign of stroke
or a tumor.
6. Dubious diagnostic tests
for suspected allergies.
American Academy of Allergy,
Asthma & Immunology
Some 35 million Americans suffer from seasonal allergies. And
millions of Americans increasingly blame a food allergy or sensitivity—from gluten to milk—for
their health woes. Some doctors
or health workers now perform
a blood test, called an immunoglobulin (IgG), for food allergies.
But Linda Cox, M.D., of the allergy academy says the test simply
doesn’t work. A positive result in
an IgG test is the sign of a normal
immune system, not a food allergy.
“It leads to a lot of confusion,” Cox
says. If you’ve been eating any kind
of food, there’s a good chance you
will develop an IgG antibody, she
says. “And that has nothing to do
with allergy.” For seasonal allergies,
many doctors run a battery of blood
and skin tests dubbed IgE, when
just a few specific tests would do.
By asking patients when and where
they have symptoms, doctors can
pinpoint what tests to run.
Dangers: The superfluous use of
medications; an overly restricted,
7. X-ray, CT scan, MRI for
low back pain.
American College of Physicians;
American Academy of Family
Low back pain is the fifth most
common cause for all doctor visits.
“The vast majority of people with
nonspecific low back pain simply
get better, no matter what you do.
And most of them get better within
four to six weeks, with or without
a physician’s intervention,” says
Patrick Alguire, M.D., an official
with the American College of Phy-
sicians. And if older people get an
image, experts say, the results will
almost always show an innocent
“abnormality” that has nothing to
do with the pain.
Dangers: Some tests expose people
to unnecessary radiation and can
lead to expensive back surgery.
Exceptions: When the doctor
suspects serious underlying con-
ditions or if the pain isn’t better in
six weeks. ;
aarp.org/bulletin MAY 2012