About 80 percent of people experience back pain at least once over the course of their lives. Low back pain is a very common condition, but it’s easy to discover the source of this pain through a number of different tests. A physical examination is usually the preliminary course of action to identify the severity of low back pain, and then from there your healthcare professional can decide if you require further imaging tests, such as an X-ray, MRI, CT scan, etc.).
Although many patients may feel that they definitely need an MRI, because their pain is so excruciating, it’s not always the best plan of action. The reason for this is that even though MRI tests create great pictures of a patient’s anatomy, they cannot necessarily show you where the source of the pain is located. In the November 2011 issue of the Journal of Orthopaedic and Sports Physical Therapy (JOSPT), a clinical commentary discussed research that shows that when MRI tests are prescribed to patients unnecessarily, they increase the rate of unnecessary surgical procedures. These surgeries have not shown consistent results in terms of significantly reducing the symptoms of the low back pain, nor have they improved patients’ daily functions.
The authors of the JOSPT article looked into the current clinical guidelines and research that is available regarding low back pain and diagnostic imaging tests. They found that MRI results often show herniated lumbar disks in patients who experience no symptoms of low back pain. In fact, some studies showed that up to 90% of healthy people over age 60 who were screened using MRI testing found bulging disks in their results. It seems that many people have bulging disks that do not affect their daily lives at all.
Many people who suffer from low back pain come to find that their symptoms correct themselves after a short period of time. Their pain could be due to muscle strain or any number of other mild injuries that just require rest and a bit of time to heal on their own. Making a decision to perform imaging for every patient who complains of low back pain is a hasty one that is often unwarranted. Certainly, imaging tests should be used to rule out more serious problems, but they shouldn’t be the standard next step following a physical examination for every case of low back pain. Studies estimate that half of all CT scans performed and one third of MRIs on the low back are unnecessary. Performing an MRI on some patients can actually be detrimental, such as those with older pacemakers, metal implants, shrapnel, or who are in the first trimester of pregnancy.
The safe and recommended treatment for low back pain is physical therapy. A physical therapist is able to perform the necessary examination to assess your low back pain and determine if further imaging investigation is necessary. In most cases of low back pain, you won’t require an MRI before you start treatment. At Physical Solutions, our trained physical therapists will work with you to build a program specific to your needs so that you can return to your regular activities as soon as possible.