Please do not volunteer to do any x-rays or MRIs before you see the doctor. You will really benefit a lot more if you leave any evaluation and decision for what kind of investigation is needed to the doctor only. Patients volunteering to do investigations on their own before seeing the doctor spend more money for unneeded investigations sometimes and, more importantly, might get really anxious and confused for investigations they did that have abnormal reports at a time when those abnormal reports might not be alarming at all to the doctor. You better avoid all this by leaving doctoring to doctors.
As for the problem of low back pain, most of us will suffer from low back pain at some time in our lives. The most common cause of low back pain is usually your lifestyle and habits; being overweight, having weak back and abdominal muscles, poor fitness levels, sitting for a long time doing desk work and so on. The diagnosis of this very common type of low back pain due to bad posture and bad habits is called Mechanical back pain or postural back pain. Patients who do not correct their habits and lifestyle will have this back pain attacks recuring over and over again and, in time, it might turn into a chronic problem.
In general, most attacks of low back pain will recover in a couple of weeks if not days with some rest and some simple treatment measures including instructions and painkillers.
Diagnosing this common back pain problem in the clinic is easy and straightforward without the need for an X-ray or an MRI of the back.
Question: So when would the doctor request an X-ray or an MRI of the back for a patient with back pain?
Answer: if the patient's symptoms were too different from the classic picture of the common mechanical back pain problem or if the pain was unresponsive to the treatment prescribed over a period of one to two weeks.
Now we have a question from a patient: Ok, if I have this common low back pain problem and I did an MRI of the back; if I volunteered to do the MRI of the lower back because I am anxious, the result will be normal?
Answer: Doesn't have to be normal but did we really need it anyway?
If the pain is chronic or recurrent over many months or years, the MRI will not be normal. It will show at least signs of osteoarthritis of the vertebrae of the lower back. A good translation for osteoarthritis for non-doctors is greying of the hair of the spine, some aging of the spine because of lifestyle and bad habits over the years. But, even if the MRI will show those signs, at the end of the day, this will not change any treatment decision that the doctor is making now. Your doctor will still prescribe the same treatment plan for you whether or not you had that MRI and that report of the MRI.
In the process of diagnosing diseases, we, doctors, request investigations to add new information that will help us confirm a suspected or pending diagnosis. We don't request investigations to confirm a diagnosis that is already quite confirmed without the need for that investigation.
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This post was prepared and published by Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for online medical consultations that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.
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