Is an MRI necessary if you have Back Pain?

Is an MRI or an X-Ray necessary if you have back pain?

No, and most studies show that if you have low back pain and receive an MRI you are more likely to have surgery, and many times surgery does not “fix” your problem. About 30% of the time, more conservative and cost effective treatments such as physical therapy are not tried first.  To be specific, a study by the Centers for Medicare and Medicaid Services found that at Moses Cone Hospital in Greensboro, NC 31.5% of outpatients (people not spending the night in the hospital) with low back pain had an MRI without trying recommended treatments first, such as physical therapy.

A recent article from NPR states:
“Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them.

And the latest Medicare data show that doctors frequently order MRI back scans for patients who haven’t tried recommended treatments such as physical therapy. An MRI often prompts surgery.

In 2009, 32 percent of Medicare patients with lower back pain who received a spine MRI at a hospital outpatient imaging center hadn’t tried a more conservative — and cheaper — treatment than surgery, according to data published on Medicare’s Hospital Compare website this month.”

“And there’s evidence — such as in this recent study — that patients receiving back scans are more likely to end up getting spinal surgery. Spine surgeries are a rapidly growing cost to Medicare, and there are widespread concerns that some spine surgeons are too eager to perform these lucrative surgeries, egged on by financial conflicts of interest.

The Medicare data show that at 9 of 10 hospitals, at least 25 percent of the patients who received back MRIs hadn’t tried a more conservative treatment first.”

Read the rest of the article at NPR here.

The main point of this post it that you do not need an MRI or X-Ray first to “tell you what is wrong” if you have low back pain.  If you have neurological signs like bowl or bladder dysfunction or numbness, your are tripping over your foot or you have a loss of sensation in both legs, an MRI is probably indicated.  If you have pain or tingling in one leg, a physical therapist can help you as well as tell you if you need to be seen by a physician for further evaluation.

The best most important thing you can do is to continue with your normal daily activities and work.  The second most important is to see a physical therapist for an evaluation and you do not need a physicians referral or prescription, so fortunately you do not have to wait very long for an appointment.  I am a physical therapist in Greensboro, NC and can help you feel better today.  Start with my back pain survival guide and call today to receive your free book on back pain and to discuss any questions you may have.

 

About The Author

Aaron LeBauer

Dr. Aaron LeBauer is a Doctor of Physical Therapy and Licensed Massage and Bodywork Therapist. He owns LeBauer Physical Therapy, LLC, with his wife Andra, in Greensboro, N.C. He has been helping active people stay fit, active and healthy without medications, injections or surgery since 1999. He earned his Doctor of Physical Therapy degree from Elon University in 2008. Dr. LeBauer graduated from Duke University in 1996 with a B.A. in History and moved to San Francisco where he studied Massage Therapy and Health Education at the National Holistic Institute. He has specialized in Myofascial Release since 2000 and is an Instructor with the John F. Barnes MFR Seminars. A native of Greensboro, Dr. LeBauer returned in 2005 to continue the third generation of LeBauers as health care professionals in Greensboro. Dr. LeBauer helps weekend warriors, high level athletes, desk jockeys, students, children and anyone with pain, stiffness return to the activities the love without expensive imaging, pain medications, injections or surgery. He specializes in treating people with chronic conditions, pain and injuries which have not responded to traditional treatments and therapies with the goal of helping patients have less pain, move better and feel wonderful in their bodies. Dr. LeBauer also helps other physical therapists start and grow successful cash-based physical therapy practices. He has developed an online training course that describes in detail how to start a small private practice, along with his marketing secrets and strategy. He is currently available for recorded telephone and video coaching sessions, email support, on-site visits and speaking engagements. Contact him for more information, rates and services.. Dr. LeBauer enjoys riding one of his vintage Vespa and Lambretta scooters or his bicycle to work. He has raced bicycles since high school and as a category 1 amateur throughout the United States. He was based out of Northern California and North Carolina and spent a very memorable summer racing in Belgium, France and the Netherlands. He enjoys working in his garden and has an edible landscape including pears, apples, scuppernogs (native muscadine grapes), raspberries, blueberries, figs, various seasonal vegetables and shiitake mushrooms. He has two beautiful daughters and an amazing wife.

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