Low back pain is one of the most common ailments for people visiting a doctor or an urgent care clinic. When the back pain becomes intense it can get you thinking something is seriously wrong with your back. The doctor might offer an x-ray or MRI scan to put your concerns at ease.

Fortunately, most cases for low back pain even acute pain improve within days or a few weeks. Most cases are remedied with chiropractic, physical therapy, heat/ice therapy and rest. And a lot of these cases do not require any form of spinal imaging. However, there are those reasons when X-ray, MRI, CT scans are necessary to figure out what’s going on.

• Strained muscle
• Sprained ligament
• Poor posture

These are typical causes of low back pain that can be painful and limit activities.

 

 

Back Pain Lasting Longer Than 2/3 Weeks

Subacute pain lasts between 4 and 12 weeks while chronic back pain lasts 3 months or longer. These are not indications of a serious low spinal condition.

Less than 1% of people with low back pain are diagnosed with a condition that may require spine surgery like:

• Cauda equina syndrome
• Spinal infection
• Metastatic spinal cancer

 

X-rays or MRI’s for Diagnosing Low Back Pain

Doctors may recommend an x-ray or MRI if the low back pain was from a traumatic injury, like a:

• Slip
• Fall
• Automobile accident

Other potential causes of low back pain may warrant medical imaging immediately or later on.

The diagnostic process starts with the evaluation of the low back symptoms and how they relate to what was found during the:

• Physical exam
• Neurological exam
• Medical history

A doctor utilizes these results to figure out whether the need for spinal imaging is necessary, along with the type of imaging test,  x-ray or MRI and the timing to confirm a diagnosis.

A Low Back X-Ray/MRI

X-ray spinal imaging is best at detecting bony structural problems but not so great with soft tissue injuries. There are X-ray series that may be performed to diagnose vertebral compression fractures like.

• Anterior
• Posterior
• Lateral views

MRI is a radiation-free test. MRI’s create 3-D anatomical views of the spinal bones and soft tissues. A contrast dye like gadolinium is used to enhance and improve the quality of the images. The contrast is injected through an intravenous line in your hand or arm before or during the test. An MRI can evaluate neurological symptoms, like radiating pain or pain that develops after being diagnosed with cancer.

Symptoms, Co-existing Medical Diagnoses, and Conditions that may Require Spine Imaging

Neurological symptoms

• Low back pain that radiates, fans out or downward into the buttocks, legs, and feet
• Abnormal reflexes in the lower body can indicate nerve disruption
• Numbness, tingling, and possibly weakness develop
• Inability to lift your foot aka foot drop

Co-existing medical diagnoses and conditions

• Cancer
• Diabetes
• Fever
• Osteoporosis
• Previous spinal fracture
• Spine surgery
• Recent infection
• Immunosuppressant medication use
• Corticosteroid medication
• Weight loss

 

X-ray Radiation Exposure

When undergoing an x-ray, the radiation not absorbed by the body creates the image. The radiation dose is the same amount every time you undergo an x-ray. Radiation to your entire body is measured through the millisievert (mSv) also known as the effective dose.

The effective dose helps a doctor measure the risk for possible side effects of radiographic imaging:

• CT scans use radiation as well
• Certain body tissues and organs in the lower back are sensitive to radiation exposure like the reproductive organs.

 

MRI Radiation-Free Why Not Just Use This Test All The Time

MRI’s cannot be used on all patients because of its powerful magnet technology. Pregnant women or individuals that have metal inside their body like a spinal cord stimulator, heart pacemaker, etc cannot be scanned with an MRI.

MRI testing is also expensive, doctors do not want to prescribe unnecessary tests that increase costs. Or because of the fine detail that MRI’s provide, sometimes a spinal issue can look serious but is not.

Example: An MRI of the lower back reveals a herniated disc in a patient that has no back/leg pain or other symptoms.

This is why doctors bring all of their findings like the symptoms, physical exam, and medical history to confirm a diagnosis and then create the custom treatment plan.

Imaging Test Takeaways

If low back pain begins to take its toll, listen to what the doctor recommends. They might not order a lumbar x-ray or MRI immediately but remember the aforementioned issues like neurological symptoms and co-existing medical conditions. But these tests do help in discovering the cause or causes of the pain. Remember this is to help get patients to their optimal health and pain-free.

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Eliminate your Low Back Pain! El Paso, TX. (2020) FOOT ORTHOTICS

 

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NCBI Resources

Imaging diagnostics is an essential element in the evaluation of spine trauma. The rapid evolution of imaging technology has tremendously changed the assessment and treatment of spine injuries. Imaging diagnostics utilizing CT and MRI, among others, are helpful in acute and chronic settings. Spinal cord and soft-tissue injuries are best evaluated by magnetic resonance imaging, or MRI, whereas computed tomography scanning or CT scans, best evaluate spinal trauma or spine fracture.