A Pain In the Back

The Role of an MRI with Lumbar/Spine Pain

Low back pain is the most common cause of disability and lost work time in industrialized countries. Research suggests that 80% of those who experience back pain recover in 6-8 weeks and do not require extensive treatment. It is important to note that recurrences and flare-ups of low back pain are normal and do not represent a failure of treatment. This is the natural history of low back pain.

Lumbar/Spine (L/S) imaging is very effective in detecting fractures, cancer, and compression of the spinal cord/nerves. Fortunately, 99% of those with low back pain do not have these serious conditions. Research has shown that anatomic variations on MRI (Magnetic Resonance Imaging), including herniated discs and degenerative disc disease, are normal findings and are common even on those without low back pain. Therefore, one should be aware that bulging discs and degenerative discs do not necessarily indicate a serious condition. In fact, labeling low back pain in this manner often convinces the patient that they have a serious problem. Research has shown that those with non-specific low back pain tend to have worse outcomes when an MRI is performed versus when no MRI is performed.

In conclusion, most incidences of low back pain resolve in the short term followed by incidences of recurrence or flare-up. 99% of the time an MRI is not necessary and may actually act to worsen symptoms by labeling a problem and creating a negative emotional response. Because of this, national guidelines call for restricting the use of MRI in patients with non-specific low back pain.


By Adam Skrove, MPT, OCS

Intecore Physical Therapy

Andrew Vertson