Unnecessary Back Pain MRIs Linked to Harmful Treatments and Surgeries, Study Finds
Doctors and medical practitioners often resort to MRI scans to identify the cause of back pain. However, a recent study published in the BMJ (British Journal of Medicine) reveals that early and unnecessary MRI scans for back pain can lead to harmful treatments and surgeries, resulting in poorer long-term outcomes.
The study, conducted as part of the International Choose Wisely Campaign, focused on more than 400,000 patients who received early MRI scans within six weeks of experiencing back pain and did not display any red flags, such as signs of cancer, infection, inflammatory disease, fractures, or severe neurological deficit. The findings indicate that individuals who underwent early MRI scans were more likely to undergo back surgery and be prescribed opioids. Moreover, these patients experienced higher pain scores at the one-year follow-up compared to those who did not undergo an MRI.
This study is not an isolated incident. There is mounting evidence that shows early or unnecessary MRI scans can lead to more invasive treatments, negative perceptions of spinal conditions, and overall, poorer outcomes. It is estimated that only 5-10% of all back pain cases display red flags that require an MRI. In two decades of treating back pain patients, the author of the study encountered only three cases with such serious symptoms. This highlights the fact that the majority of back pain patients do not require an MRI for an accurate diagnosis and treatment plan.
MRI scans provide a comprehensive view of the spine, revealing common findings like bulging discs, arthritis, stenosis, and degenerative discs. These findings are often considered a normal part of aging and can be present in individuals with or without back pain. However, these common findings are frequently blamed for back pain when identified on an MRI. Research shows that it is not reliable to correlate MRI findings with the true cause of back pain. Studies comparing MRI scans of individuals with and without back pain have demonstrated that they can have almost identical results. Martin Underwood, co-author and professor at Warwick Medical School, warns against treating disc degeneration solely based on MRI findings, stating that it is often unrelated to a patient’s back pain.
Approximately 70-80% of all back problems, including sciatica, are categorized as mechanical in nature. Mechanical back pain is diagnosed through repeated movement testing to identify triggers and relievers of pain. MRI scans cannot accurately diagnose mechanical back pain, but it can be effectively treated with corrective movement strategies aimed at eliminating and preventing pain. Undergoing an MRI for mechanical pain can lead to unnecessary treatments that can worsen the problem. It is essential to exhaust all conservative treatment options before considering invasive procedures or surgeries, as back surgeries cannot be reversed, and complications related to them can be challenging to treat.
Patients who have been suffering from back pain for an extended period should seek the expertise of a mechanical back pain specialist who can accurately determine the root cause of the pain using corrective movement strategies instead of relying on an MRI. It is crucial to give the body a chance to naturally resolve back pain through non-invasive treatments rather than resorting to unnecessary procedures.
Dr. Carrie Jose, a physical therapist and Pilates expert who owns CJ Physical Therapy & Pilates in Portsmouth, emphasizes the importance of seeking conservative and natural treatment options for back pain. For more information about her services or to request a seat in her upcoming Masterclass for Back Pain & Sciatica, visit her website at www.cjphysicaltherapy.com or call 603-605-0402.
