Is an MRI or an X-Ray necessary if you have back pain? No, and most studies show that if you have low back pain and receive an MRI you are more likely to have surgery, and many times surgery does not “fix” your problem. About 30% of the time, more conservative and cost effective treatments such as physical therapy are not tried first. To be specific, a study by the Centers for Medicare and Medicaid Services found that at Moses Cone Hospital in Greensboro, NC 31.5% of outpatients (people not spending the night in the hospital) with low back pain had an MRI without trying recommended treatments first, such as physical therapy.
A recent article from NPR states:
“Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them. And the latest Medicare data show that doctors frequently order MRI back scans for patients who haven’t tried recommended treatments such as physical therapy. An MRI often prompts surgery.
In 2009, 32 percent of Medicare patients with lower back pain who received a spine MRI at a hospital outpatient imaging center hadn’t tried a more conservative — and cheaper — treatment than surgery, according to data published on Medicare’s Hospital Compare website this month.” “And there’s evidence — such as in this recent study — that patients receiving back scans are more likely to end up getting spinal surgery. Spine surgeries are a rapidly growing cost to Medicare, and there are widespread concerns that some spine surgeons are too eager to perform these lucrative surgeries, egged on by financial conflicts of interest. The Medicare data show that at 9 of 10 hospitals, at least 25 percent of the patients who received back MRIs hadn’t tried a more conservative treatment first.” Read the rest of the article at NPR here.
The main point of this post it that you do not need an MRI or X-Ray first to “tell you what is wrong” if you have low back pain. If you have neurological signs like bowl or bladder dysfunction or numbness, your are tripping over your foot or you have a loss of sensation in both legs, an MRI is probably indicated. If you have pain or tingling in one leg, a physical therapist can help you as well as tell you if you need to be seen by a physician for further evaluation. The best most important thing you can do is to continue with your normal daily activities and work. The second most important is to see a physical therapist for an evaluation and you do not need a physicians referral or prescription, so fortunately you do not have to wait very long for an appointment. I am a physical therapist in Oakland, CA and can help you feel better today. Start with my back pain survival guide and call today to receive your free book on back pain and to discuss any questions you may have.
Pro+Kinetix Physical Therapy & Performance specializes in helping active individuals in Oakland, Alameda, Berkeley, Walnut Creek, and San Francisco get back to exercising and working out pain free without having to take time off or relying on injections/pain medication. Pro+Kinetix offers rehabilitation and performance services to all populations, with specialties in Sports Rehabilitation, Active Release Techniques, and Manual Therapy Techniques plus Personal and Small Group Training, Sport Clinics and Wellness Services.