“Get an MRI,” will undoubtedly be a frequent comment you hear from well intentioned friends and family if you’re going through a significant case of low back pain. Or, maybe you’re the one wondering whether or not you need a scan so that you can fix the problem and return to full function?
Maybe you don’t understand why your doctor recommends waiting, or even conservative treatment (such as chiropractic care and rehabilitation) for a period of time before considering the MRI...
Can the MRI scanner reveal why your back hurts so much or what to do about it?
Well, maybe, but it’s not that simple.
Here are 3 reasons you may not have considered that your doctor might want to wait on the MRI:
1. MRI can be misleading. Human brains love to find cause and effect relationships, and sometimes this can lead to disaster. It’s just too tempting to assume that the observed abnormality is the CAUSE of the pain. Countless unnecessary surgeries have been performed on spines because of an abnormality on an MRI found in a person who has low back pain even though the abnormality was not related to the symptoms.
2. MRI can cause unnecessary long lasting fear and anxiety. As above, findings on MRI are often not related to a low back pain episode, but once a patient has seen and heard about abnormalities (which may be completely benign) on an MRI, those images and words will never be forgotten. This can often have lasting effects in worry and fear that can lead the patient towards chronic low back pain through avoiding activity.
3. MRI is really expensive. The thousands of dollars spent on an MRI might be better utilized to get the care and rehabilitation that is appropriate in the vast majority of low back pain cases.
The decision to use diagnostic imaging for lower back pain is complex.
There is certainly a time and a place for MRI, and in certain situations, it’s required to best evaluate a patient.
However, like X-ray, it’s not the answer for every case of low back pain, even when the pain is severe. It must be used and interpreted in context with history and examination findings by a skilled provider in order to help you achieve the ultimate goal: