Ask a Physical Therapist: Do I need an MRI?
One of the most common questions I receive from my patients suffering from low back or neck pain is whether or not they should get an MRI. It’s a fair question — it’s no fun to deal with the pain that doesn’t seem to go away or that shoots down your leg or arm.
So, it makes sense why folks would want to have this type of imaging performed. MRIs will show what is wrong, and the problem can then be fixed, right?
Not necessarily.
What is an MRI?
MRIs are powerful diagnostic tools. They provide excellent pictures of your anatomy and detect severe diseases like tumors, cysts, and abnormalities in the brain, spinal cord, and other body tissues.
You may be saying to yourself, sounds like the perfect test to tell me what is wrong, right?
Not always!
The issue is that the MRI is so powerful it detects every imperfection of the tissues. Some of these low back or neck imperfections include disc bulges, stenosis, arthritis, and degenerative joints. All of which are normal occurrences of the aging process.
The problem here is that the MRI may not pinpoint the specific source of your pain. For example, just because your MRI finds you have a bulging disc doesn’t mean it is the cause of your lower back pain!
Studies prove MRIs are not always the answer.
Don’t believe me? Look what the research shows: A study by Nakashima et al. in 2015 looked at the MRI findings of over 1200 individuals with NO neck or radiating arm pain. Of these volunteers, a shocking 87.6% had a bulging disk!
Several other MRI studies performed on healthy, pain-free individuals’ lower backs showed between 60-80% had bulging discs on their MRI.
If so many people without low back discomfort have these findings on MRI, can we confidently conclude that these findings are the actual cause of their symptoms?
Making assumptions based solely on MRI findings often leads to over treatment and even potential surgery. Additionally, the more testing and treatment a patient undergoes, the more likely fear and anxiety become associated with persistent or chronic low back pain.
Don’t get me wrong, MRIs are excellent medical tools. However, they may not be the best option for pinpointing the exact cause of one’s low back or neck pain. They also can be very expensive and lead to unwarranted surgery.
How long does an MRI take?
If you find yourself having to undergo an MRI scan, then you might be wondering just what to expect when you go for your appointment. An MRI scan generally takes about 30-60 minutes unless you need an MRI with contrast. These can take a bit longer.
An MRI with contrast is used when the scan needs to be more detailed to look at a problem area. For example, these types of MRI scans can highlight areas of inflammation. In addition, they will sometimes be injected directly into a joint to help paint a more detailed picture of the root cause of pain and other symptoms a patient is experiencing.
How much does an MRI cost?
MRI scans can be very costly. According to Bankrate, the average MRI scan cost will range from $400 to $3,500. This can be a significant determining factor for patients deciding the best course of action to determine what is causing their pain. Patients may be able to work with their insurance, but based on the plan they have. They may face having to pay a significant portion out-of-pocket or have it apply toward their deductible. MRIs are eligible for use with a flexible spending account (FSA) or a health savings account (HSA), making it more affordable for some patients, but they may choose a different treatment plan for others.
It is essential to understand that sometimes, MRI scans are necessary to help diagnose an underlying medical issue. However, there is strong evidence that an MRI may not be required for some patients when diagnosing your chronic pain. Therefore, it is best to discuss all available options with your doctor and your insurance company.
Difference between MRI and CT scan
Differentiating between different kinds of scans and procedures can get confusing, not to mention frustrating. So I am here to break down and explain the difference between MRI and CT scans.
Both are used to capture images of the inside of a patient’s body, but the method and equipment are different. In addition, they are used to capture information about other parts of the body.
MRI scans are used for gathering images of a patient’s joints, brain, wrists, ankles, breasts, heart, and blood vessels. On the other hand, CT scans are used for learning more about a patient’s internal organs, blood vessels, and bones. Many times, CT scans are recommended for diagnosing stroke, cancer, and problems with blood flow.
The equipment used is also different — an MRI uses radio waves while CT scans use X-rays.
When should I get an MRI?
Physical therapists are trained to focus on improving a patient’s pain and function and figuring out if the problem is genuinely a musculoskeletal issue or something more serious needing immediate attention. For example, if you have had a fall, traumatic accident, noticing progressive weakness, bowel or bladder problems, or pain that does not improve over time, then an MRI is warranted.
However, something to consider is that up to 80% of back pain people experience during their lifetime is mechanical. Mechanical back pain is caused by placing abnormal stress and strain on the muscles of the vertebral column.
It typically results from bad habits such as poor posture, poorly designed seating, and incorrect bending and lifting motions. Mechanical back pain comes and goes, and at times can spike and become very unruly.
Is there such a thing as an open MRI?
An MRI uses a unique piece of equipment enclosed around a patient (in a tube-like shape) and sometimes requires a patient to lie still for an extended period. As a result, patients may suffer from an anxiety or panic attack, but the good news is that there are different options and ways for patients to complete an MRI without panic.
Open MRIs are “open” in that the shape allows a patient to see more and have more of their body out of the machine than a traditional MRI. The latter uses a cylindrical shape but the open MRI does NOT surround the body. For many patients, an open MRI might be a better solution.
Suppose you have to have a traditional MRI for whatever reason. In that case, there are ways to manage your anxiety. Some methods include asking any questions you might have before the scan begins, covering your eyes (or using an eye mask), listening to music, and asking for a blanket to keep you warm (if possible, based on the type of scan being done).
Physical therapy benefits for chronic pain
Don’t want to have to undergo an MRI? Here’s the good news: One of the most effective mechanical neck or back pain treatments is specialist physical therapy. At Move Empower Concierge Physical Therapy, our spine specialists are trained to evaluate and treat spine pathologies. Our hands-on manual therapy techniques quickly and effectively restore your mobility and function to get you back to activities you love to do.
Are you suffering from lower back or neck pain and have been urged to get an MRI? Curious if specialist physical therapy could help you determine what is going on? If so, reach out to Move Empower today at 512-659-5615 to speak to a physical therapist! Together, we can work with you to find a treatment plan specially tailored to your needs.