MRI and X-Rays almost useless for back pain.

November 15, 2017

"MRI and X Ray often worse then useless for back pain". This was an article from that can be found here (…/mri-and-x-ray-almost-useless-…). While the site and author may or may not be a top notch source of information, the thoughts and perspective presented I believe are spot on. He uses excellent references from peer reviewed journals and cites them (unlike a lot of others who post information on the web.)

It is unfortunate when patients feel the need to delay starting PT because they think they need (or are waiting for) imaging first. As noted here, sometimes the reports actually create barriers to recovery. The fact is most patients with low back pain (LBP) are best off seeing a Physical Therapist (PT) as their first line provider. Though medical doctors are skilled at screening for disease, and trauma, they are not equipped to help a patient with acute LBP outside of providing medication or ordering imaging. A licensed PT is also trained and skilled at recognizing trauma and pathology that requires further workup. They would refer you to an MD if indicated. On the other hand, unlike your MD they treat patients with LBP all the time and have the knowledge and skill to actually reduce and alleviate your pain.

I did a search for "abnormal MRI findings in normal people" and it came back with over 2 million results. The first was "brain abnormalities found in 1 of 8 healthy people". Educate yourself, and put trust and value in an approach and treatment like MDT (Mechanical Diagnosis and Therapy). Clinical decisions should be made on real world data like your pain and how it responds to movement and loads. Compare that to a static image taken of your spine while lying down in a tube. It's a night and day comparison. Expensive and fancy is not always better. I can't tell you how many people I would have failed to get better if I relied on an MRI finding to guide my treatment. Imaging simply reveals anatomy, it cannot and does not reval how that may or may not be causing your actual pain. An outstanding number of normal and healthy people have pathology that can be found on MRI and other imaging. Keep this mind if you are having pain and seeking further diagnostic information. You are likely a lot better off seeing a good PT first. They will treat you and your body as the dynamic fluid entity it is. A saying that I like is "clinical response never lies" (meaning if a movement or position reduces your pain and makes you better, it doesn't matter if an imaging study would support that or not. After all, most patients just want to feel better and get rid of their pain.

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