The purpose of imaging testing
Images of the inside of the body are produced through imaging tests like X-rays. Some go into greater detail on this than others. Doctors occasionally do imaging studies on patients with low back pain to try to visualize the structures inside the back.
The most popular imaging procedures are:
- X-rays are good at displaying abnormalities with bones, but they are less effective at displaying concerns with soft tissues. (Soft tissues include muscles and the pliable discs positioned in between the spine’s bones.) A bone infection, some types of malignancies, damaged or misaligned bones, or both can all be seen on an X-ray. If back discomfort is brought on by an injury, such as a fall, X-rays may also be taken.
- CT scans are a particular sort of X-ray. They are significantly more detailed than X-rays, but they also cost more and expose you to more radiation. All of the disorders that X-rays reveal, as well as other soft tissue issues, can be seen on a CT scan.
- MRIs – Magnetic resonance imaging (MRI) uses strong magnets rather than radiation to produce images. Compared to CT scans, they provide better soft tissue information. Because they have metallic implants in their bodies that could be damaged by the magnet, some people are unable to have MRIs. Additionally, MRIs are frequently expensive, and patients may have to wait to have them.
If I have low back pain, do I need imaging?
Most people with low back pain do not require imaging.
People frequently anticipate the worst when they have acute back pain and assume their back is seriously damaged. The majority of back pain instances, even the most severe examples, are actually brought on by minor issues. Most low back pain cases resolve on their own or with straightforward therapy.
Unless you experience one of the symptoms listed below, do not request or anticipate receiving an imaging test right away if you see the doctor or nurse with low back discomfort.
In the first 4 to 6 weeks after developing low back pain, the majority of patients do not require an imaging test.
The majority of the time, it makes no sense to order the test earlier because, regardless of what an imaging test would reveal, the treatment for the majority of low back pain reasons during the initial few weeks is the same.
Even without an imaging test, your doctor or nurse can learn a lot about your pain from talking to you and performing an examination, including what might be causing it and how to manage it.
Without an imaging test, how can the doctor or nurse determine what is wrong?
Your doctor or nurse will perform an examination and ask you questions if you have low back discomfort, including:
- Do you only suffer back discomfort, or does it also affect your buttocks and lower leg?
- Is there equal pain on both sides, or does one side suffer more from it than the other?
- Do you experience any weakness, tingling, or numbness?
- Does bending forward make the ache go away?
- Do you experience any issues when peeing or going to the bathroom?
Your doctor or nurse will have a decent sense of what is wrong with your back based on the exam results, your responses to these and other questions, and other information. If you have certain signs (listed below), the doctor or nurse will probably order an imaging test because they think you might have a dangerous condition.
Who needs imaging examinations?
Imaging studies should frequently be performed to look for the source of pain in people who have experienced it for 4 to 6 weeks or longer. The doctor or nurse might wish to immediately arrange imaging testing for patients who exhibit particular symptoms. This encompasses those who:
- Had a recent mishap or injury (such as a car crash or a fall)
- They’re older
- Have back discomfort and a fever or weight loss that aren’t related
- Those who take “immune suppressants” or “steroids”
- Possess diabetes
- Have a history of cancer
- Use injectable substances, such as heroin
- Have osteoporosis, a bone-weakening condition
- Jave issues with bladder or bowel control or leg weakness
- Have a condition known as “foot drop,” which is when you are unable to keep your foot raised, as when walking
Why not get checked up with an imaging test?
Although most people believe imaging exams are innocuous, they are not. The X-rays used by doctors to try to diagnose back pain expose your pelvic organs (such as your ovaries or testicles) to the same amount of radiation as receiving a chest X-ray every day for more than a year. You are exposed to greater radiation during CT scans.
Although MRIs don’t expose you to radiation, there are still risks involved. People who undergo MRIs (or other imaging tests) are significantly more likely than non-subjects to undergo surgery and other invasive procedures. Even for those who do not require surgery, this is true. This is due to the fact that “abnormal” findings on back imaging tests are highly frequent, even in those who do not have back pain. While abnormal findings can be alarming, they don’t always indicate that medical attention is required.
It is acceptable to question your doctor or nurse if they believe you do not require an imaging test for low back pain. Many of the back pain cases that doctors and nurses see eventually get better and don’t require imaging tests. They can work with you to develop a treatment plan that you understand and are comfortable with, and they can explain to you why imaging is not currently required.