When may a low back x-ray or MRI be recommended? Combined, your doctor utilizes these results to determine the need for spinal imaging-as well as the type of imaging test (eg, x-ray, MRI) and timing to confirm a diagnosis (eg, cause of your lower back pain). Keep in mind, the diagnostic process starts with the doctor’s evaluation of your lower back symptoms and how they relate to findings from your physical and neurological examination and medical history. Of course, that doesn’t mean other potential causes of lower back pain do not warrant medical imaging immediately or at a later time. Your doctor may recommend an x-ray or MRI if your lower back pain resulted from traumatic injury, such as a fall or car accident.
1 What role does x-ray or MRI play in diagnosing the cause of lower back pain? In fact, less than 1% of people with lower back pain are diagnosed by their primary care doctor with a condition that may require spine surgery-such as cauda equina syndrome, spinal infection or metastatic spinal cancer. Rarely is subacute (pain lasting between 4 and 12 weeks) or chronic back pain (pain lasting 3 months or longer) an indication of an urgent lumbar spine condition. But what about lower back pain that lasts longer than 2 or 3 weeks-does that indicate the need for an x-ray or MRI to diagnose a spinal disorder that may be serious? A strained muscle, sprained ligament or poor posture typify causes of low back pain that can be extremely painful and possibly limit your activity level yet can be easily treated without the need for spinal imaging tests. Many lower back pain cases improve in days or a few weeks.
X-rays are often called the 'workhorses' of the radiology department and this type of spinal imaging test best detects bony structural problems. But, as hard as it may be to believe, the cause of most cases of lower back pain (even acute pain) is not serious and undergoing a spinal imaging test is probably not necessary. Perhaps you ask the doctor for an x-ray (ie, plain radiographs) or MRI (ie, magnetic resonance imaging) to relieve your concerns. Severe low back pain may lead you to think something is seriously wrong with your lumbar spine. Lower back pain is one of the most common reasons why people visit their doctor or go to urgent care.
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