Over the past few years, researchers have expressed growing concerns about the potential overuse of MRI machines. The images provided by MRIs are far more detailed than X-rays and, in some cases, make the diagnosis of certain conditions, such as disc herniation, possible. In many other cases, however, the test is likely not useful.
Many cases of chronic back pain go unresolved, since the cause of pain is often not some visible spinal abnormality. Still, patients may be eager to see an image of their spines to rule out possible injury, and doctors may be quick to accommodate them. But there are a couple good reasons to avoid an unnecessary MRI.
One is simply the cost of the imaging test. Insurance companies don’t always offer reimbursements for MRIs. A single scan can cost anywhere from $400 to several thousand dollars, with the exact price varying by location. If your insurance company decides you don’t need it, or if you’re uninsured, this is no small expenditure.
But who wants to put a price tag on his or her health? No one, of course, but having the test may do you no good or, worse, some harm. Most people who are in their 20’s or older have signs of spinal wear and tear. Many people have bulging or herniated discs with no symptoms – or, if they have the symptom of back pain, it may not be related to an abnormality that shows up on an MRI. False positives can result, determining the course of your treatment and steering it in the wrong direction entirely.
Overuse of MRI technology is, according to a recent study, not limited to the United States. Researchers assessed 300 cases of MRI prescription to lower back pain patients for adherence to clinical guidelines. After reviewing patient histories and examination records, the researchers found that only 20% of orders were deemed necessary, while 24% were uncertain. Fifty-six percent were concluded to be inappropriate prescriptions of the imaging test. These inappropriate tests posed a notable economic burden.
See more on this study at www.ncbi.nlm.nih.gov.
If you have signs of nerve impingement – pain, tingling, numbness and/or weakness that travel along a nerve path in the lower body – along with lower back pain, then an MRI is in order. If you are missing these red flag symptoms and show no signs of spinal joint damage or a vertebral fracture, an MRI may do nothing more than cost money and, at worst, give you and your doctor a false impression about what is causing your pain.
If you’re lacking red flag symptoms that would merit an MRI but would like to cover your diagnostic bases, consider seeking out a physical therapist skilled in analyzing posture, body mechanics and gait. If the root of your back pain lies in the soft tissues, there’s a good chance that the way you hold and use your body is involved.