Is an MRI worth doing for Low Back Pain?
There is a common saying in the healthcare field, "If you hear hoof beats it is more likely to be a horse than a zebra." It suggests that most times there is a common and reasonable explanation, and there isn't anything super crazy going on inside the body. Once in a great while there will be zebras, but there will also be other signs suggesting that this is not an ordinary horse.
MRIs are a tool; they can be used to confirm or disprove a diagnosis. Sometimes this is very necessary to do before starting a treatment. The American Medical Association has been saying for years that we should refer people less for MRIs because it isn't necessary or helping the patient. If it looks and sounds like a horse, do we need a test to prove it is not a zebra?
Low back pain, back sprains, and strains are very common. Most people will be affected by low back pain at some point in their life.
It really annoys me when a person hurts their low back for the first time, has consistent back sprain signs, and is sent for an MRI before any other treatment is performed. This happens all the time with moderate back injuries that hurt in the low back (localized pain) and doesn't radiate down a leg. The pain is increased with certain positions and is relieved with other positions that suggest muscle and joint sprains; these are all common and consistent signs of a low back sprain. If the history, orthopedic, and exam findings suggest a sprain then we are talking about a very common back sprain.
In this case we hear hoof beats and horse neighing sounds, smell horses, are standing in horse waste, and we parked the car under a sign that read "welcome to our horse ranch;" yet we are looking for zebras before getting any appropriate treatment. This process causes a patient to experience more pain for a longer period of time. Treatment and rehab is going to take longer because of the delay in getting appropriate treatment for their sprain.
Your chiropractor and physical therapist work with sprains, strains, muscle pulls, and disc problems every day. If the horse does start acting like a zebra then they are in a great position to notice and refer you for an MRI.
Back pain is very common in your chiropractic and physical therapy office. They are very knowledgeable about diagnosing and treating low back disc herniations, back sprains, and muscle pulls. The treatment they provide in the first few days after an injury can dramatically change your progression of pain. Research has shown that the most important time frame in any low back injury is in the first 10 days, don't waste that time getting an MRI or seeing a specialist who is most likely going to send you for therapy before trying other treatments anyway.
For more information on Low Back and Sciatica click here.
Disc herniations information can be found on the Lumbar Disc Decompression page.