MRI for Back Pain: Be Careful What You Ask For

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Published on February 08, 2016

MRI for Back Pain: Be Careful What You Ask For

By: David Coran, MD

MRIPatients with back and neck pain frequently ask their doctor if they need an MRI scan to diagnose and treat their problem.

Their doctors answer "no" for most of these cases. There are many reasons why their doctors should not make MRIs a routine order.

Most important, research has shown that MRIs do not improve the outcomes for the majority of patients.

"Back pain is a very common condition, and in most instances is benign and self-limited,' says David Coran, MD, Spine Specialist and Orthopedic
Surgeon. "Simple treatments such as heat, over-the-counter anti-inflammatories, and an exercise program will often lead to quicker recoveries from back pain than MRI studies can provide."

In addition, MRI scans are very sensitive. They show fine details of the body's deep tissues including the discs, bones and nerves of the spine. These studies often reveal changes in the spine that are natural and age-related. MRIs reveal disc degeneration in 20 percent of 20-year-olds, 40 percent of 40-year-olds, and more than 80 percent of patients over 60 who do not have any back pain!

“Disc herniations and spinal stenosis are also frequently seen in asymptomatic patients on MRI scans," says Dr. Coran. "MRIs can over-diagnose back problems and may lead to invasive and often unnecessary treatment."

The use of MRI should be limited to cases with certain "red flag" warning signs. These include weakness in the extremities; history of cancer, fevers, or infection; and loss of bowel or bladder control. An MRI can often diagnose serious conditions in these situations that require urgent or emergency surgery. "Without these red flags, an MRI can be considered if symptoms persist for at least six weeks despite treatment,” Dr. Coran says.

The team of spine specialists associated with Midwest Orthopedic Specialty Services is specially trained to provide accurate diagnosis and
treatment for your back pain and can determine whether an MRI will be helpful or not. Our ultimate goal is for the best outcomes for our patients.