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Should I get an MRI?You may be thinking to yourself should I get an MRI and is it necessary right now? Advanced imaging is very useful when performed at the right time.  However,  imaging is not always necessary right away for acute episodes of low back pain.   You can reference a previous post on MRI or click on the link below for a recent summary of best practices regarding use of advanced imaging.  MRI’s are often over-read or over-interpreted and this leads to increased and unwarranted invasive and/or surgical referrals (see Patterns of Care After MRI).   There are many studies that point to the lack of correlation between imaging findings and patient symptoms.   Moreover, imaging does predict outcomes.   That is, your picture does not determine how you will progress.   Do not misinterpret my position.  MRI is a valuable tool when used appropriately.  Indiscriminate use of imaging increases cost, reduces effectiveness and sometimes creates the setting for mismanagement of non-complicated issues.  On a related topic, our general health is a key indicator to the development of chronic pain syndromes.  Specifically, the study below highlights that people with poor blood sugar regulation, increased BMI and self assessed low quality of life tend to develop of chronic pain syndromes more often.  Difficulty coping, fear of  movement and early pain-induced disability also increase the risk of chronicity.  The first link provides excellent advice on dealing with back pain with a few exceptions.

  1. As a general rule, use ICE during the 1st three days after injury or exacerbation.  Would you put heat on a recently sprained ankle?  Heat is best used during the healing phase or for long standing pain.
  2. See a non-surgical spine specialist 1st–Chiropractor or Doctor of Physical Therapy.   This saves time and cost associated with a haphazard and circuitous attempt to self treatment back pain.  

 Happy reading! Enjoy the holidays…

 

When You Need Imaging Tests for Low Back Pain

Prognostic Factors of Prolonged Disability in Chronic Low Back Pain

Patterns of Care After MRI