Should I have an Xray or MRI scan for my back pain?
There are many reasons why people consider this question and rightly so. Some of us simply like to see what is going on and have an explanation for what we are experiencing in terms of pain etc, but we should also consider the usefulness of imaging too and indeed the negatives of it besides radiation.
We know as fact that Xray and MRI imaging will often show us things that bare no relationship to the pain we are feeling. We know as fact that the vast majority of people Xrayed will show signs of arthritis, but yet have no pain. We know as fact that up to 1/3rd of under 30 year olds MRI’d will show disc prolapses without pain. These are all ‘findings’, but are they helpful to us or are they harmful?
We also know that when people are told they have arthritis and disc prolapses they also often develop abnormal movement patterns and fear avoidance behaviours, which sadly can then also lead to pain. When people are told in depth about their findings they are also then more likely to focus on their pain and the details of ‘what is wrong’, developing more of an ongoing pain cycle and dysfunctional movement patterns. We see this regularly with patients, often presenting as a new patient to see us, with bags of scan results and images of multiple disc prolapses. Whilst these can be helpful, there is often a negative connotation of there is nothing that can be done and this must be bad, but this is often simply not the case. Whilst we are not suggesting there is no problem, as the images may show a far from ideal spine, this does not directly often correlate to the person as a whole.
Imaging is fantastic, used in context of the whole presentation. It can help us when we suspect damage, for example a fracture from trauma or osteoporosis. It can help us to rule out nastier things and red flags. It can help us build a picture of the person in front of us, taking in to account what they present with and their clinical findings, BUT it is only part of the picture.
For more help and advice, speak to our team or your GP. We are all here to help you!
The link below is the London Imaging Centre, which we at BOP use for private referrals for imaging. Check out their information on the link if you are interested.