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It has become common practice for patients with low back or neck pain (with or without arm/leg numbness or tingling) to have an MRI. However, recent studies have shown that having an MRI does not lead to an improved ability to determine a diagnosis and does not help you to get better any faster than if you did not have the MRI.1,2 In fact, these tests can actually result in unnecessary treatments, having worse pain or being in pain for a longer period of time than you would if you didn’t have the MRI, and can cost you more money than if you avoid the MRI. So how can having an MRI result in more pain? Based on research, roughly 2 of out every 3 people without any pain have “abnormal” MRI findings.3 These findings in pain-free individuals consist of bulging and/or herniated discs, stenosis (narrowing of the spinal canal), and arthritis, just to name a few.3 Yes, that is right, 2 out of every 3 people without pain have MRIs that show something “wrong”. Having an MRI often results in more confusion for all involved parties when trying to determine your diagnosis. This means you may be told that you have spinal conditions that are actually normal in pain-free individuals. The following table reveals higher incidence of surgery, injections, and visits to spine specialists and the ER for patients who have had an MRI before receiving physical therapy care, and these differences were unrelated to the severity of the patients’ symptoms.4  So how can we know that the findings from an MRI have anything to do with your current pain? We often can’t, and it actually doesn’t matter. The cause of low back pain cannot be identified in > 80% of patients.5 Most back pain goes away within 1 month, and many times this doesn’t even require any treatment.6 When treatment is needed, physical therapy is often enough to help you overcome your symptoms in a short period of time, even in those cases when there is numbness and/or tingling down the arm or leg. Let’s discuss an example to explain how your symptoms can worsen by having an MRI. You develop sudden onset back pain with tingling in your left calf and foot. Your physician prescribes medication and orders an MRI, which reveals a bulging disc on the left side. You should now know that 50% of pain-free 40 year olds have bulging discs and this percentage rises steadily with age. While waiting to get the MRI results, valuable time has passed that could have been used to initiate appropriate treatments designed to help you overcome your pain. What should I do if I am currently experiencing, or start to experience back or neck pain? Seeking out the correct physical therapist is likely your best option, as we are musculoskeletal experts and have the ability to perform a competent physical examination in order to determine whether or not you actually need an MRI. If we determine that you don’t need an MRI, we can use the information gathered during our assessment to provide treatments that are proven to decrease your pain and disability. Current research shows the 2 most important factors to getting better the fastest are: 1. Getting treated as soon as possible after the onset of pain, and 2. Getting the appropriate treatments.4 Remember that in New York State you are allowed to go directly to your physical therapist without a referral from your physician. Give us a call today if you are having any pain and we’ll get you back on track. Physical therapists that are Fellowship or Residency trained in evidence-based practice make up only 5% of clinicians in the country due to this advanced level of training. All of our clinicians here at PRO-Active Physical Therapy have their Doctorate in Physical Therapy and are Fellowship or Residency trained. Call us today for more information about this topic. PRO-Active Physical Therapy, North Syracuse, NY. 315-458-2552. References:
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