MRI and other modern advancements in imaging have long been used in the diagnosis and assessment for low back pain, but does it even provide any value?
Short answer: Most of the time, NO!
Long answer: The 2016 ACOEM guidelines recommend that patients suffering from low back pain only have an MRI if they have specific nerve damage AND do not respond to treatment or if surgery is an option. There are some “red flags” that doctors may have to rule out, but generally speaking, patients should first complete 6 weeks of care before even being considered for this procedure.
Why Avoid the MRI?
According to the research, patients who have an early MRI have increased medical costs and do not have improved benefits. As a result, there are worse outcomes that are likely.
How is it Possible to be Worse After an MRI?
After getting the results of the imaging, it is more than likely you will have something come up positive! As a result of the aging process, it is more likely to find some degenerative changes. Many degenerative findings are likely part of normal aging and are not associated with pain. Due to this, doctors can actually be rambling off false positive findings that are not causing you pain. This can contribute to fear and anxiety of the patient.
Patients who believe or even entertain the idea that they have a problem within there low back often are subjects to what I call “fear based diagnosis.” This means they actually fall into the trap of believing everything that was diagnosed.
You should not believe everything you are told! Not even if it is coming from you doctor or radiologist! Believe it or not, most MRIs that were taken cannot be validated correctly. A study had noted that the interpretation of the MRI had been vastly different and that there were interpretation errors. This finding suggests that the diagnosis and the outcome of the patient can be very different.
After following a low back pain incident, the guidelines recommend that you should seek at least 6 weeks of conservative prior to an MRI. If you do get an MRI, know that you will likely have some positive findings. Finally, don’t fall into the fear based diagnosis and believe all the results you hear because the interpretation is likely erroneous.