To get a MRI for your back pain or not. That is the question.
Since it's invention in the late 1970's, magnetic resonance imaging (MRI) has saved countless lives and diagnosed countless pathologies all over the world. Unfortunately, the MRI has delivered disappointing results when it comes to diagnosing the cause of lower back pain in many patients.
Did you know that the #1 predictor
if a person will get spinal surgery for lower back pain is a person’s ZIP CODE. The #2 predictor:
if a person gets an MRI. Studies also demonstrate that if a patient sees a surgeon first for their back pain, they are more likely to get surgery than if they see their PCP or chiropractor first for that same back pain complaint. However, surgery as a first intervention results in higher costs overall but no improvement in outcome compared to conservative care.
Additionally, it has been found that MRI findings do not necessarily correlate with pain and dysfunction in the lumbar spine. In 2015, there was a research study done that examined MRI results in over 3,000 people WITHOUT back pain. According to the study, 37% of people over 20 years old had disc degeneration; 88% of those over 60 years old had spinal degeneration; 30% of 20 year olds had disc bulges; and 69% of those over 60 years old had disc bulges. NOBODY in the study had pain.
What does this mean?
That you can have spinal degeneration, disc bulges, disc protrusions etc. and be completely pain- free. Do disc bulges cause pain? YES, but not always! Can spinal degeneration cause back pain? YES, but not always! Differentiating the many different causes of back pain can be best done by a conservative care provider, such as an experienced chiropractor, who will give you an appropriate and individualized treatment to help minimize your pain and get you back to feeling your best.
Is an MRI needed to diagnose your back pain?
Well, not if you are like most people. An MRI is a good idea for those people who have certain severe findings as they may require immediate attention, but for the majority of people getting an MRI is not necessarily going to tell you what is causing your lower back pain and should not be done before conservative care has been tried first.
If you are having lower back pain seek professional care by a chiropractor or physical therapist and see what results you get from conservative care. There are certain situations that MRIs are very helpful, but in general it should usually only be obtained as a next step if conservative care is not producing the results you were after. If you get an MRI early in your course of care that shows a disc bulge or degeneration of your spine, it may or may not be causing your pain but now you have spent more money getting it and are more likely to get surgery even though the outcome may not be any different.
Lastly, pain is illusive, and the first step in getting ahead of your pain is to seek professional help from a conservative care specialist to get you out of pain, functioning better and healing quicker. Your first line of defense should always be the easiest, cheapest and safest option, which is conservative care.