Do I Need an MRI for Back Pain?
Dr. Abby Dante's three reasons below are adapted from her own explanation. The guidance on warning signs is general patient-safety information, not a diagnosis.
By Dr. Abby Dante, DC NY License #013032 Last updated
Should I get an MRI for back pain?
An MRI can be a useful piece of information. Dr. Abby is clear that it is by no means useless, but it is just a single piece of the puzzle, and on its own it might not be telling the whole story of your pain. So find a provider who will look at the whole picture, not just the imaging.
She gives three reasons why your MRI might not be telling the whole story, and they're below in her words. When imaging is the right call, and when to see a physician instead, has its own section.
What does a bulging disc on an MRI mean?
Dr. Abby's first reason: pain-free people have abnormal scans all the time. In her words:
“About 30% of people in their 20s who are pain-free will still have some type of disc bulge on their imaging. Once you get into your 50s, just about everybody has some type of structural finding on their imaging, but that does not mean that it's causing your pain.”
So a disc bulge or another structural finding on your report is one piece of information. On its own, it doesn't mean that finding is what's causing your pain.
What does an MRI show for back pain, and what doesn't it?
Her second reason: imaging is a snapshot. For an MRI you're lying down, with no movement and no load.
That means the scan shows your structure. As Dr. Abby puts it, “It's not showing anything about your function, solely relying on your structural findings.”
And in many cases, pain occurs when you're moving, not when you're lying still.
Why can two people have the same MRI and different symptoms?
Her third reason: an MRI can't take into account all the other factors. It isn't looking at your sleep, your stress or your nutrition.
That's why, in her words, “two people can have the same scan and yet completely different symptoms.”
When should you get an MRI for back pain, or see a physician?
General guidance — not specific to your case. When in doubt, call your physician.
See a physician or go to the emergency room the same day, not a chiropractor, if you have back pain with numbness in the groin or inner thighs, new loss of bladder or bowel control, leg weakness that is getting worse, back pain with a fever or weight loss you can't explain, back pain after a recent significant fall or injury, or back pain and a history of cancer.
Otherwise, if your pain hasn't improved in a few weeks, get it evaluated.
Should I get an MRI before seeing a chiropractor?
You don't need to arrange imaging before you book. If you already have a scan or a report, bring it with you. It's useful alongside a physical assessment. Whether imaging would change your plan is something Dr. Abby will talk through with you at your first visit.
Is it worth getting an MRI for back pain?
Dr. Abby's answer: “While an MRI is by no means useless, please just remember it is just a single piece to the puzzle.” Her advice is to find a provider who will look at the whole picture, and not just the imaging, to help you build a plan for you and your goals.
How we look at the whole picture
We start with what a scan can't see: you, moving. A movement assessment is us watching you move before we put hands on you, to see what you avoid, where you compensate and which movement actually brings your symptoms on. It's the first part of your first visit, one-on-one, in a visit of 30-60 minutes, and it gives us a baseline to re-test against as your plan goes on.
Not sure whether you want a chiropractor or a physical therapist for this? Here is our honest comparison of a chiropractor vs physical therapy. If your pain is mostly in your back, see what to expect from a chiropractor for lower back pain; if it came from sport or training, start with sports injury rehab.
Call or text 631-212-2996 and tell us what's going on. You can read Dr. Abby's training and license, and find us in Islandia and Quogue.
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