Should I Get an MRI for Low Back Pain?

 

Have you considered getting an MRI as the missing piece of the puzzle in finally living a life without back pain?

Unfortunately, this is the sentiment we hear far too often from our clients living with chronic low back pain. The longer the pain continues, the more strongly you might consider an MRI as the best option. 

Imaging is recommended so often for a variety of medical conditions that we've become conditioned to believe imaging findings will finally give us an idea of what is going on and what we should do about it.

But, what if we told you all of this imaging has the potential to cause more harm than good?

Don't get us wrong, there is most definitely a time and a place where imaging is critical, but for general chronic low back pain research found starting with an MRI is often more harmful than it is helpful.

Surprised? So were the researchers who were discovering the potential harm in our healthcare system's practice of ordering imaging for every complaint of pain.  

Why Imaging Can Be Harmful

As we discussed in a previous post, aging of the spine is NORMAL. Completely normal. In a majority of cases, an MRI will show some kind of degeneration of joints, bulging discs, or a combination of both. But neither of these findings tend to predict levels of pain well. 

This doesn't mean that your pain isn't real. The pain is very real, and in a majority of cases tissue damage is not the only contributing factor.

In fact, 60% of adults over 60 years of age will show abnormal MRI results, regardless of whether or not they have pain. Which tells us the pain is likely not 100% the result of what is being found on the MRI. 

In other cases, people have chronic low back pain and an MRI will show no abnormal results. And sadly, this often leaves them feeling hopeless. The back pain is still there, but because no damage was found they feel left without answers. 

After that MRI is completed and someone is given the report with results, they often have images of their spine exploding or crumbling seared in their mind. We assume what the MRI is telling us is that there is no hope and that we will live the rest of our life in pain. 

But Remember... These Scary-Sounding Findings are Highly Normal!

We want you to know your body is very resilient! Your spine is a highly stable structure, one wrong move won't just cause the whole thing to crumble. That being said, we can be more mindful of how we move for pain relief but we don't encourage avoiding certain movement because of a misguided belief your spine might fall apart. 

Researchers found both increased health costs and increased use of invasive procedures associated with the use of medical imaging for back pain. We cannot repeat enough, structural abnormalities on MRI are a normal finding and may not be the cause of pain. However, findings on imaging tend to dictate treatment. This can lead clinicians down the wrong path to identifying and treating the source of your low back pain.

So What Should You Do Instead?

As we said before, there is a time and a place where use of imaging for low back pain is necessary. Both x-ray and MRI have the potential to detect fractures, cancer, and other serious conditions that need immediate treatment. However, red flag symptoms should be present for one of these conditions to be suspected (ex. loss of bowl or bladder control, excruciating or unrelenting pain, etc.).

After ruling out any red flag symptoms, exploring conservative treatment options like improving sleep quality, promoting an active lifestyle, stress management, or limiting inflammatory foods is the best step! 

Exercise is MUCH more effective than rest for reducing pain levels. There is no one specific type of exercise that has benefit over another in terms of pain, so the best program for you is one that you will be excited enough to do! Anything from dancing, to yoga, to walking, to Crossfit all have huge benefits not just for back pain but overall health. It might take a little trial and error but there's no reason you can't get started today. 

If you really aren't sure where to start, a trained professional, such as a physical or occupational therapist, can help you set and prioritize goals to find what activity will fit your lifestyle. Reach out to us at info@advancedbalance.org to schedule a FREE consultation call if you would like our help in getting started on the right foot.

And finally, if imaging has been recommended for you have a discussion with your medical provider about why they feel it is needed and what all of your options are. This might end up being one of the most important discussions you have about your back pain! 

Sources:

  1. Savigny P et al. Low back pain: early management of non-specific low back painLondon: National Collaborating Centre for Primary Care and Royal College of General Practitioners NICE Clinical Guidelines Vol. 88, May 2009.

 

Get your free copy of our Ebook: 5 Simple Steps to Take Control of Your Chronic Pain to finally have an understanding of where your pain is coming from and start taking action TODAY!

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