Do I need a scan for my back?

We get asked this question by many clients and unfortunately the answer is not a simple yes or no for everybody.

There are many factors that influence whether your physiotherapist will send you for any kind of medical imaging or if they will refer you on to a doctor that may do the same.

Is an x-ray or MRI necessary to treat my back pain?

It may sound strange but for the majority of people, back pain imaging doesn't change what course of action and what treatment is used.

So why is this?

Medical imaging such as MRI scans show incredible detail. So much so that it picks up changes that have occurred not only in your recent past but also from years ago.

Studies have shown that scans performed on people with no back pain reveal things like disc bulges and osteoarthritis and that tells us that despite these being seen they are not necessarily a cause of pain.

A physiotherapist’s clinical assessment is the most important tool to assess what is going on and what needs to be done.

Further reading: How to prevent low back pain

But I'm in a lot of pain - won't a scan tell me what's wrong?

Back pain can be horribly disabling, cause incredible fear, stress and anxiety. However back pain is common. More than 80 per cent of people experience back pain in their life.

Medical imaging can be helpful if conservative treatment is not progressing and may also be used if there is any suspicion of other things that may be occurring in the back.

However the clinical assessment of your physiotherapist is the best guide of what course of action needs to be taken.

Severity of pain is not a reason to get an x-ray or MRI as this does not indicate more or less damage.

In fact, research has shown that getting scans done early on can worsen the long term outcomes of back pain.

This is because of the nature of pain and the way it works.

We will leave you with a couple of (hopefully) thought provoking questions: How can a football player not feel pain when their arm is broken during a game? Conversely, how can a paper cut of so little damage and consequence hurt so badly?