I Have Back Pain. Do I Need an MRI?

Back pain brings more patients into a clinic than most other ailments. When your back hurts, you want relief and quickly. Unfortunately, not all back pain is easy to diagnose even with the use of advanced diagnostic equipment.

Many patients who experience back pain immediately ask for imaging studies to be done, specifically an MRI (magnetic resonance imaging). While an MRI can provide detailed pictures of inside the body, the images are often incomplete. Without knowing the causative nature of the injury, an MRI may provide little to no benefit to either you as a patient or for your doctor in diagnosing your problem.

Before jumping straight into imaging studies, your doctor will want to take a much more complete and detailed history of your back pain, including your family history, whether you have any evidence of muscular instability, or other problem responsible for your back pain.

MRIs can produce both false positive and false negative results. Patients sometimes bring in MRI proof that they have a bulging disc, but upon further questioning, report that they actually are feeling little to no pain. Other patients may have a soft tissue lesion that is not seen on an MRI but causes the patient a great deal of pain.

MRIs are expensive tests to run and often unnecessary as they are not as fully diagnostic with regard to back pain. Additionally, MRI results may not even change the care approach your doctor has chosen. In general, a patient reporting back pain is not enough of an indication to order an MRI. Studies have shown that imaging without a serious underlying condition does not improve patient results. Because of this, your doctor will likely refrain from using an MRI unless a more serious underlying condition is suspected. Other approaches will be tried first.