Physiocare Rimbey

Imaging Tests for Low Back Pain

Close up of man rubbing his painful back isolated on white backg

Back pain can be excruciating. So, it seems that getting an X-ray, CT scan, or MRI to find the cause would be a good idea. But that’s usually not the case, at least at first. Here’s why:

They don’t help you get better faster:

Most people with lower back pain feel better in about a month whether they get an imaging test or not. In fact, those tests can lead to additional procedures that complicate recovery. For example, one large study of people with back pain found that those who had imaging tests soon after reporting the problem fared no better and sometimes did worse than people who took simple steps like applying heat, staying active, and taking an over-the-counter (OTC) pain reliever. Another study found that back pain sufferers who had an MRI in the first month were eight times more likely to have surgery, but didn’t recover faster.

They can pose risks:

X-rays and CT scans expose you to radiation, which can increase cancer risk. While back x-rays deliver less radiation, they still can give 75 times more radiation than a chest x-ray. That’s especially worrisome to men and women of childbearing age, because x-rays and CT scans of the lower back can expose testicles and ovaries to radiation. Furthermore, the tests often reveal spinal abnormalities that could be completely unrelated to the pain. Those findings can cause needless worry and lead to unnecessary follow-up tests and procedures such as injections or sometimes even surgery.

When do imaging tests make sense?

It can be a good idea to get an imaging test right away if you have signs of severe or worsening nerve damage, or a serious underlying problem such as cancer or a spinal infection. “Red flags” that can alert your health care provider that imaging may be worthwhile include:

  1. A history of cancer
  2. Unexplained weight loss
  3. Fever
  4. Recent infection
  5. Loss of bowel or bladder control
  6. Abnormal reflexes, or loss of muscle power or feeling in the legs.

If none of these additional symptoms is present, you probably don’t need an imaging test for at least several weeks after the onset of your back pain, and only after you’ve tried the self-care measures.


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