Low Back Pain and MRIs

by Frank J. Klene, PT, DPT, CSCS 

Low back pain is the most common orthopedic injury seen by physical therapists and general practitioners. 80 percent of the population is reported to experience some form of back pain in their life. In some regard, back pain is a consequence of our upright bipedal nature with our spines taking the brunt end of our daily activities.

The good news is that a good physical exam done by your physician or physical therapist can determine what course of action needs to be taken in terms of treatment or imaging. Often, back pain can be severe enough a patient may think they need an MRI. However, many times an MRI is an unnecessary step to directly treat your pain based on several factors:

1. MRI findings such as herniated discs and arthritic changes are commonly seen in healthy individuals without back pain.
2. Many patients show signs of recovery shortly after the onset of low back pain.
3. Studies have shown that overuse of MRIs for patients with low back pain is related to an increase rate of surgical procedures that have not historically been shown to significantly reduce the pain.

For practical purposes, an MRI should only be used when a serious underlying condition is suspected, like progressive numbness and tingling of the legs or difficulty using the restroom - and only if the results of the scan will change the course of treatment. 

But more times than not, physical therapy is a great early course of treatment for low back pain and if started early can speed up the healing process! 

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