Is MRI needed for all Backache?

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Backache is a very common problem encounter in orthopedic clinics. It is more common in young female and older people. There are many causes of back pain. It is very common for primary care providers to request MRI of the spine as soon as patient presents to them with backache. The question arises whether MRI is required for all the backache or not?

To answer this question, we need to understand the common reasons for backpack in young population. The most common causes include musculoskeletal or muscular spasm. Other causes are pelvic inflammatory diseases in female of childbearing age, nutritional deficiencies (vitamin D and calcium) related problems, bad posture, and stressful lifestyle. Sedentary lifestyle is also associated with increased risk of back pain. People who have high BMI also suffer from back pain more commonly. There are also multiple other causes of back pain.

There are other causes of back pain including a nerve compression from sciatica, bulged disc, bone disease, cancer in the spine and other unusual causes. Luckily these cases are far less than the one mentioned above.

Usually, patient presents to orthopedic surgeons with an MRI and multiple prescriptions of multiple anti-inflammatory medications and quite a few of multivitamins but still they do not have any firm diagnosis except backache which is a symptom rather than the final diagnosis.

All causes mentioned above which commonly causes back pain do not require any imaging especially MRI. If there are any red flags including a persistent localized pain, weight loss, fever or high inflammatory markers in the blood, those patients may require CT scan or MRI.

Patients need full assessment of their symptoms and thorough examination of their back and neurological examination of legs to develop differential diagnoses. If there are any red flags, then they should proceed to have an imaging of the back. Otherwise, we should just manage with anti-inflammatory medications and physical therapy.

If you are worried about any persistent backache, you can consult Dr Usman Kazi at Australian Polyclinic, DHA Phase 5 Lahore.

Dr Muhammad Usman KhalidKazi


Assistant Professor of Orthopedic Surgery

King Edward Medical University, Lahore

Consultant Orthopedic Surgeo

Australian Polyclinic

CCA Phase 5 DHA, Lahore

0311 057 3333




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