(Part 2 of a 4 Part Series)
Thanks for clicking to read my second blog on the Muscle IQ Blog Page! Today’s blog is about Low Back Pain and getting an MRI. When I had my first MRI 30 years ago my doctor showed me what was wrong with me and was able to explain why I needed to have surgery. MRI’s are amazing. What I like to tell my patients is that an MRI is great for showing your surgeon where to put the scalpel. My surgery was a success and I had a great recovery. That is how I was first introduced to Physical Therapy and was the reason I decided to become a physical therapist.
There are reasons why you should get an MRI when you are suffering from low back pain. Here are what I would consider the Top Three Reasons to get an MRI of your back:
Severe low back pain and recent onset of loss of bowel or bladder control (Cauda Equina Syndrome?) Germon T, Ahuja,S, Casey A, Rai A. British Association of Spine Surgeons standards of care for Cauda Equina Syndrome. The Spine Journal 2015 15 (3), pS2-S4.
Severe low back pain accompanied by a significant weight loss that was not expected. (Spinal Tumor/Cancer?)
Severe low back pain with radiating pain, tingling and or numbness down one leg that shows no improvement with physical therapy (Lumbar Herniated disk)
Do I need an MRI before starting therapy at Muscle IQ?
The most recent consensus is that “Imaging is not recommended unless alerting features of serious conditions are present.” Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 2010;19:2075–94 (Level of evidence 1A) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997201/
So, the answer is No, you do not need an MRI before starting physical therapy at Muscle IQ because during the first visit we will take a thorough past medical history and perform an evaluation that will identify whether you have any “alerting features of serious conditions” and send you on for the appropriate care. During your physical therapy sessions we will also continue to monitor your progress and if things are looking wrong we will recommend you to appropriate further care. If you are unsure what to do just give us a call.
Can a MRI predict how much low back pain I will have in the future?
One reason to wait to get an MRI is that it is not a good predictor of future low back pain. A recent study looked at 50 people over a ten year period. Each person had an MRI of their low back and then another MRI 10 years later. The people were asked about their incidents of low back pain during that 10 year period and the researchers concluded that there was nothing on the MRI that was able to predict which people were going to have episodes of pain and which people were not going to have episodes of pain.
“baseline MRI findings were not associated with LBP history during the 10 years; therefore, our data suggest that baseline MRI findings cannot predict future LBP.” The associations between magnetic resonance imaging findings and low back pain: A 10-year longitudinal analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687715/
The best course of action is to get started on the road to recovery as soon as possible. If you are having low back pain give us a call at 1-801-310-0851.
My next blog will address the importance of doing the right exercises for low back pain.