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When Should I Get An X-Ray or MRI?

X-Ray or MRI? Charleston natives are very active! We run, surf, exercise, and do all kinds of fun activities. Sometimes things happen and injury occurs. Now what?! Don't worry, Made 2 Move is here to help you get out of pain and back to doing the things you love to do!

“Should I get an X-ray or MRI?” This is a question that we get at Made 2 Move all of the time. This is one of the first questions many patients experiencing unexplained or chronic pain ask at the beginning (or prior to) their first physical therapy session. It seems logical that getting an image would help to “see” what the issue is or what is causing pain.

However, a recent study on spinal imaging “found no evidence that the use of routine or repeat radiographs [x-rays] to assess the function or structure of the spine, in the absence of red flags, improves clinical outcomes and benefits patients” (Corso et. al 2020). As we will discuss in future blogs, the “tissue is not always the issue,” which is one of the reasons imaging can be such an impractical step in resolving pain or injury.

The issue with imaging

  1. X-rays and MRIs can be an unreliable indicator of injury.

Studies have shown that ⅓ of asymptomatic people who displayed a disc bulge on an MRI never experienced any back pain. The disc bulge was likely a result of normal aging while their back pain was a result of weakness in the back that needed strengthening. Once a doctor points to abnormalities on an image or puts words like “arthritis”, “wear and tear,” or “disc bulge” in someone’s head, they are going to likely attribute their pain to that ailment and avoid the activities (lifting weights, movement, etc.) that could ameliorate the pain.

Studies have also been done on patients with pain in one shoulder that volunteered to get imaging done in the non-painful shoulder. What did the researchers find? The prevalence of abnormalities (arthritis, bursitis, partial tears) were just as common in the healthy shoulder vs. the painful shoulder. The same situation has been found in those with knee pain.