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MRIs and low back pain

Description

Back pain and sciatica are two of the most common health complaints. Almost everyone will have back pain at some time in their life. Most of the time, the exact cause of the pain cannot be found.

An MRI scan is an imaging test that creates detailed pictures of the inside of the body. When back pain is bad enough to keep you from work or activities that you enjoy, you might think an MRI scan will help find the cause of pain and help you heal sooner. This is not always true, though.

When you need an MRI scan

Both you and your health care provider may be worried that something serious may be causing your low back pain. Serious illnesses, such as cancer or infection in your spine, can cause back pain. How can your provider know if a serious problem is causing your pain?

Certain warning signs suggest that a serious cause of back pain may be present. Your provider is likely to recommend an MRI scan if you have:

  • Trouble passing urine or stools
  • Trouble controlling your urine or stools
  • A hard time walking and keeping your balance
  • Fever
  • Had cancer in the past
  • Other signs or symptoms of cancer
  • Fallen or had a serious injury recently
  • Back pain that is very severe, and not even pain medicine that your provider prescribed for you is helping
  • Numbness or weakness in one leg that is getting worse
  • Abnormal curvature of your spine

A provider may advise that children with severe back pain have an MRI scan.

When an MRI may not be needed

If you have low back pain but none of the above warning signs, getting an MRI right away will NOT lead to better treatment, better pain relief, or a quicker return to activities.

Remember:

  • Most of the time, back pain is not caused by a serious medical problem or injury.
  • Most of the low back pain gets better on its own.

MRI scans create detailed pictures of your spine. They can pick up most injuries that you have had in your spine in the past. Because of this, they often find small problems or changes that are not the cause of your current back pain.

These findings of past problems will rarely change the treatment your provider first recommends for your current pain. But small problems or changes seen on MRI scan can lead to:

  • Your provider ordering more tests that you may not really need.
  • Worrying more about your health and your back even more. If these worries cause you to avoid exercise that could help your back heal, your back could take longer to heal.

Your provider may want to wait before doing an MRI. If your pain does not get better, or if it becomes worse, your provider will likely advise you to have an MRI scan.

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Review Date: 4/3/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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