From the Guidelines
You should not attempt to diagnose your back pain by looking at MRI pictures, as accurate interpretation requires specialized training and expertise from a medical professional, such as a radiologist or spine specialist, to correlate the findings with your symptoms and medical history. MRI interpretation is a complex process that involves understanding the clinical context and correlating the imaging findings with the patient's symptoms and medical history 1. If you're experiencing back pain and have had an MRI, you should schedule an appointment with your doctor to review the results together. They can explain what the images show, whether there are findings like herniated discs, spinal stenosis, arthritis, or other conditions that might be causing your symptoms.
Some key points to consider when evaluating back pain and MRI findings include:
- Many MRI abnormalities can be seen in asymptomatic individuals, and imaging patients without symptoms is often not beneficial 1.
- MRI may be helpful when there is back pain with radiculopathy or signs of spinal stenosis, which suggests the presence of demonstrable nerve root compression 1.
- The goal of imaging is to identify potential actionable pain generators that could be targeted for intervention or surgery 1.
- CT myelography, radiography, and other imaging modalities may also be useful in certain situations, such as assessing the patency of the spinal canal or evaluating spinal deformity 1.
Your doctor can then recommend appropriate treatment options based on the MRI findings and your specific symptoms. Self-diagnosis from medical imaging is not recommended, as subtle findings can be easily misinterpreted, and some MRI findings may not actually be the source of your pain. It's essential to work with a medical professional to determine the cause of your back pain and develop an effective treatment plan.
From the Research
MRI and Back Pain Diagnosis
- MRI scans can be used to produce cross-sectional images of the body, which can help diagnose the cause of back pain 2.
- Studies have shown that MRI results can change clinical management decisions in the planning and delivery of lumbar spine injections 3.
- However, the accuracy of MRI results in evaluating structural pathology in the lumbar spine is not always conclusive, and other factors such as clinical findings and physical exams should also be considered 4, 3.
Limitations of MRI in Diagnosing Back Pain
- MRI findings may not always correlate with clinical symptoms, and other conditions such as epidural hematoma, neurilemoma, or lung cancer metastasis may be present 4.
- A study found that viewing MRI results did not significantly impact outcomes in patients with radiculopathy undergoing epidural steroid injection (ESI) 3.
- Another study found that pain intensity change patterns after epidural injection were highly heterogeneous, and MRI-confirmed lumbar disc herniation may not always be the cause of pain 5.
Clinical Decision-Making
- Physicians may order MRI studies to correlate with physical exams and to detect the presence of certain conditions such as synovial cysts or tumors 3.
- MRI results can influence clinical decision-making, and changes in treatment plans may occur after viewing MRI results 3.
- A study found that the most common reasons for altering the injection plan after viewing MRI results were different level affected, facet pathology, and different nerve root affected 3.