Back Pain Outpatients Who Received MRI Before Trying Recommended Treatments

What does this measure tell you about a hospital's use of MRIs for low back pain?
Although MRIs can be helpful for diagnosing low back pain, MRIs can be used too much.

• Usually, low back pain improves or goes away within six weeks and an MRI is not needed.
• Standards of care say that most patients with low back pain should start with treatment such as physical therapy or chiropractic care, and have an MRI only if the treatment doesn't help.
• Finding out whether treatment helps before having an MRI is better and safer for most patients because it avoids the stress, risk, and cost of doing MRIs that patients don't need.

If a number is high, it may mean that the facility is doing unnecessary MRIs for low back pain. For some patients with certain conditions, getting an MRI right away is appropriate care. Patients with these conditions are not included in this measure.

If you have low back pain, you, your doctor, and the medical imaging facility staff should all talk about the best time to do an MRI if you need one.

What is an MRI?
An MRI (magnetic resonance imaging) is a test that uses a powerful magnetic field and a computer to produce detailed pictures of the inside of the body (bones, organs, and other body parts).

What are the risks of having an MRI?

• Since MRIs use magnets rather than X-rays, there is no radiation risk. However, because the magnets attract some kinds of metal, it's important for the technician to know if there are any metal objects or implants inside the patient's body, such as pacemakers, artificial joints, screws, stents, plates, or staples. Metal objects can pose serious risk to the patient and interfere with the test.
• For some MRIs, a substance called "contrast" is injected before the test to make parts of the body stand out more clearly on the images. Risks of contrast include possible harm to the kidneys or allergic reactions. Contrast shouldn't be used if it isn't needed.
• Having the test can be stressful for some people. Patients must hold still for about 15 to 45 minutes while lying on a table that moves inside a large scanning machine. While images are being taken, the machine makes loud noises.