Why an MRI is Unnecessary for Low Back Pain

October 29, 2018

MRI for low back pain
JayDee Vykoukal, DPT

With statistics showing that low back pain affects approximately 80% of the population at least once in their life, chances are you have had low back pain or know someone who has experienced it.  Despite a large amount of research and information out there related to low back pain, treatment can be ambiguous.  When dealing with your spine health, it is important to know the facts so you can make an educated decision for treatment.

The low down on low back pain.

Low back pain is characterized by a general aching around the spine below the level of the ribs, typically caused by a strain from poor movement or posturing.  Severity can range from an annoyance to debilitating.  No matter the exact cause or severity, the good news is that about 65% of people with low back pain will experience a full recovery within 6 weeks, regardless of how it is treated.  This pain is considered a chronic issue when it goes past 12 weeks, potentially warranting more specialized treatment.

So you have back pain, now what?

The old school belief of extended bed rest for back pain is outdated and poorly supported by research. What current research has found is most effective is continuing with movement.  The type of movement or exercise isn’t so important as long as it is relatively pain-free. Movement can even be encouraged with normal daily tasks, such as work, with a good office set up using items such as a standing desk or desk bike.  The important thing is listening to your body to find the right balance of movement and rest. Treatment can also include things like massage, alternating ice and heat, anti-inflammatory medication, meditation, stretching, gentle movement, addressing daily postural habits, and managing stress. Research is mixed with these interventions but they feel good anyways so it definitely won’t hurt to try.

What to do if it doesn’t gradually go away on its own.

If you’re back pain gets worse despite self-treatment or becomes a more chronic issue that is affecting your daily life it can be helpful to seek professional help.  What’s great is there is a large variety of medical professionals that can help.  This may include but is not limited to an orthopedist, chiropractor, massage therapist, acupuncturist, physical therapist, or yoga instructor.  All will have slightly differing opinions on what the key to recovery is for you.  What is important is finding someone that shares your health beliefs so you can work together to get lasting relief.  If your pain is severe and/or long lasting, don’t get scared into thinking you have to get an MRI.

Why an MRI is expensive and unnecessary.

Several studies over the years have been completed to determine the efficacy of imaging to determine the cause of low back pain.  The results are always the same: imaging, particularly MRIs, do not help treat general low back pain.  There is no correlation between what can be found on an MRI and the symptoms someone may be having.  They also cannot predict current or future back health issues. The biggest problem is there are plenty of people walking around with what would be considered a “problem” on an MRI with no symptoms.  While in the reverse, someone with severe pain may not show anything detrimental on their imaging results.  Thus, for the money and anxiety associated with such imaging, it’s just not worth it. It can lead to unnecessary treatment such as surgery and rapidly add up expenses and time away from work or other daily activities. No matter how severe, PAIN alone is never a reason for getting an MRI (or the surgery it may lead to).

What does warrant an MRI?

Some things do require imaging. Red flags such as severe neurological symptoms that put a person at risk for falls, paralysis and chronic weakness and/or numbness warrant further assessment.  These types of symptoms are typically caused by excessive pressure on the spinal cord or nerves and do need to be addressed quickly to minimize tissue damage.

Be smart.

Don’t let anyone scare you into unnecessary imaging.  The negatives associated with an MRI don’t balance out any positives to make it a reasonable recommendation.  Low back pain is definitely a common and ambiguous health issue today, but getting educated and taking the reigns of your own health are key.

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