X ray of spine

If you have low back pain, do you need a scan?

If you have back pain and are concerned, would an X-Ray or an MRI Scan be helpful?

It might surprise you to know that we very rarely recommend scans for back pain as in the vast majority of cases they don’t provide any useful information and at worst they can actually cause more harm and worry. 

Studies have shown that wear and tear in the low back is incredibly common. One study of individuals in their 20s in 2014 showed 37% had some evidence of degeneration in their low back but none had ever had any pain. The table below shows the percentage of people in the general population with disk issues and yet not a single one of them has ever had any back pain. 

back pain and scans graph

So what does this tell us? 

It tells us that wear and tear in the spine is just a normal part of ageing and usually not associated with pain and if we scan someone with back pain we are very likely to find evidence of disk issues

but these are more than likely just incidental findings and were there before their pain even started. So wear and tear is a normal part of life and usually completely painless. 

So why might a scan be harmful to someone with back pain?

The issue arises when people with back pain get a scan and it contains findings of wear and tear and they aren’t given any context. This can lead to unnecessary worry and anxiety. When we worry or are anxious it triggers our fight or flight response which heightens the nervous system making us more sensitive to any negative sensations we feel such as pain. This increase in pain then leads to even more stress and worry. So in short scans often find wear and tear but this more often than not has nothing to do with your pain and just leads to more worry which then leads to more pain. 

Are the any instances when a scan is appropriate?

As always there are exceptions and if we see any red flags in your presentation that are a cause for concern we will always send someone for imaging but thankfully this is rare. 

The bottom line. 

If you are struggling with back pain and you are concerned or don’t know what to do we offer free 15 minute consultations to answer any questions or concerns you might have. Just press the book now button below or call our reception on 0208 088 0442. 

If you want to know more about how we can help you please click the button below. 

If you have any questions just drop us a line on 0208 088 0442 or email oliver@hickshealth.com and as always i will do all i can to help!

Take care and thanks for reading


This page was reviewed by Oliver Hicks M.Ost 2nd Novemebr 2023

Leave a Comment