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MRI and low back pain

Backache - MRI; Low back pain - MRI; Lumbar pain - MRI; Back strain - MRI; Lumbar radiculopathy - MRI; Herniated intervertebral disk - MRI; Prolapsed intervertebral disk - MRI; Slipped disk - MRI; Ruptured disk - MRI; Herniated nucleus pulposus - MRI; Spinal stenosis - MRI; Degenerative spine disease - MRI

Back pain and sciatica are common health complaints. Almost everyone has back pain at some time in their life. Most of the time, the exact cause of the pain can't be found.

An MRI scan is an imaging test that creates detailed pictures of the soft tissue around the spine.

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DANGER SIGNS AND BACK PAIN

Both you and your health care provider may be worried that something serious is causing your low back pain. Could your pain be caused by cancer or infection in your spine? How does your provider know for sure?

You will likely need an MRI right away if you have warning signs of a more serious cause of back pain:

If you have low back pain but none of the warning signs just mentioned, having an MRI won't lead to better treatment, better pain relief, or a quicker return to activities.

You and your provider may want to wait before having an MRI. If the pain does not get better or becomes worse, your provider will likely order one.

Keep in mind that:

An MRI scan creates detailed pictures of your spine. It can pick up most injuries that you have had in your spine or changes that happen with aging. Even small problems or changes that are not the cause of your current back pain are picked up. These findings rarely change how your provider first treats you. But they can lead to:

MRI SCAN RISKS

In rare cases, the contrast (dye) used with MRI scans can cause severe allergic reactions or damage to your kidneys.

The strong magnetic fields created during an MRI can cause heart pacemakers and other implants not to work as well. Newer pacemakers can be MRI compatible. Check with your cardiologist, and tell the MRI technologist that your pacemaker is MRI compatible.

An MRI scan can also cause a piece of metal inside your body to move. Before having an MRI, tell the technologist about any metal objects that you have in your body.

Pregnant women should not have MRI scans.

References

Brooks MK, Mazzie JP, Ortiz AO. Degenerative disease. In: Haaga JR, Boll DT, eds. CT and MRI of the Whole Body. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 29.

Joyce AA, Isaac Z. Low back pain. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 81.

Mazur MD, Shah LM, Schmidt MH. Assessment of spinal imaging. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 274.

Masdeu JC, Ajtai B, Faridar A. Structural imaging using magnetic resonance imaging and computed tomography. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 40.

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Review Date: 7/28/2021  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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