Many people think that if their back hurts, they should have an x-ray or other type of imaging procedure (MRI or CT scan).

In fact, according to The State of Oregon Evidence-Based Clinical Guidelines Project, if your back pain is the typical type caused by muscle or ligament strain, you do not need an x-ray, MRI, or CT scan.

If you don’t really need imaging, it’s better not to get it. Here’s why:

  • There are risks involved with imaging tests. For instance, the radiation exposure a series of x-rays for the low back gives you is roughly equivalent to 65 chest x-rays.
  • In most cases it won’t speed your recovery.
  • It may lead to further treatment you may not need. An image will often find things that are a natural part of aging, assumed to be the cause of pain, but turn out not to be. There is a tendency to want to do something about it, and this often leads to additional procedures or even surgery.
  • Imaging tests typically don’t pinpoint the cause of pain, and treatment recommendation is basically the same (limit bed rest, remain as active as tolerated, use heat and non-prescription painkillers).

Of course there are situations when imaging is necessary. The Guidelines do recommend that physicians should order diagnostic imaging for patients when a serious underlying condition is suspected, such as:

  • Cancer
  • Spinal Column Infection
  • Vertebral Fracture

Or when:

  •  Your back pain is from an accident or injury such as a fall or a blow
  • There is evidence of a “pinched nerve” affecting your leg for more than a month
  • There is extreme weakness in your legs

Of course, no list replaces the expertise and judgment of your physician. Consult with your doctor to see if diagnostic imaging is right for you.

For the full detailed recommendation, please visit the “State of Oregon Evidence-based Clinical Guidelines Project for Advanced Imaging for Low Back Pain” on line.


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