Should I get scans for my lower back pain?

I have been given a referral to get imaging

So, you've been written a referral to get imaging done on your low back. You’re probably wondering if it's worth the cost and if it will show anything at all. 

The TRUTH is, most MRI’s in people over the age of 30 will show some form of abnormality or “degenerative change”. This may be a disc bulge, nerve root impingement, bony spurs or other forms of degeneration. It all sounds a bit concerning, BUT, this doesn’t always have a direct correlation with the pain you may be experiencing. In fact, there is research showing a very poor correlation between those suffering low back pain and degenerative changes on an MRI. This is because many, many asymptomatic individuals will also have these degenerative changes occurring in their spines.

It's important to get imaging quickly if you have these symptoms

Getting a scan quickly is important when there are symptoms of a serious condition like Cauda Equina Syndrome (a rare condition where the nerve roots at the end of the spinal cord are compressed causing symptoms of urinary retention and altered sensation). This needs urgent medical attention. If there are no significant neurological symptoms and no bladder or bowel involvement, rushing off for a scan shouldn’t be the first priority. Often the scan will not show any results that change the treatment significantly. Therefore, things like strengthening muscles, lengthening muscles, working on controlling your movements through core stabilisation for example and waiting for these conservative measures to have effect is the preferred option, which is where we can help as physios. 

A lot of the time, with common pain presentations, the source of the pain can be identified by a health professional in the clinic without any scan results. For example, a physiotherapist can identify arthritis or ligament damage through a series of questions and physical tests…no imaging required. Of course, for ligament injuries, a scan can be useful in determining the degree of damage, but this will not have a significant impact on what they will do to treat your condition.

The more cost effective approach is to begin treatment with a thorough assessment to determine diagnosis

So, that brings us back to the initial question: should I go for that scan? In short, it's unlikely to be necessary straight away, the more cost effective way to begin your treatment is to check in with your trusted health professional and undergo an assessment with them. Physiotherapists are the experts in this situation. We are the best trained in doing a thorough assessment to come to a diagnosis in the clinic with a series of questions and tests. We can work with your Doctor if you’ve already seen them, and if we think the Doctor needs to be more involved, we can liaise with them directly to streamline your treatment. Oftentimes, an accurate diagnosis and appropriate path of rehab can be started straight away without the pricey imaging. If in the rare circumstance the pain doesn't respond to this management after a longer period of time than expected, they may use their clinical judgment to send you for the scan after all

Why wait! Book your assessment with our trusted physiotherapists

If this sounds like the situation you are in, feel free to give us a call at Swan Physiotherapy (08 9274 6711) to discuss your circumstance or book online http://www.swanphysiotherapy.c... We would be happy to have you in for an assessment to see what is going on and if physiotherapy can help you! If we can't treat you, the assessment is 100% free!


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