Is Getting a MRI for Back Pain Harmful?

Short answer: having a lumbar MRI does not cause worse health outcomes — but getting one when it isn’t clinically necessary is associated with worse outcomes for many people.

That distinction matters.

What the research consistently shows

Large, high-quality studies have found that early or unnecessary lumbar MRI (especially within the first 6 weeks of back pain, without red flags) is linked with:

  • Higher likelihood of ongoing pain

  • More medical interventions (injections, surgery, specialist visits)

  • Greater disability and time off work

  • Higher healthcare costs

  • No better long-term pain or function outcomes

In other words:
📸 More imaging does not mean better recovery

Why can MRI be linked to worse outcomes?

1. Normal age-related changes get medicalised

Most people over 30–40 will show things like:

  • Disc bulges

  • Disc degeneration

  • Facet joint arthritis

  • Annular tears

These findings are extremely common in people with NO pain.

When patients see these words on a report, they may:

  • Believe their spine is “damaged”

  • Become fearful of movement

  • Avoid activity

  • Expect surgery or passive treatment

👉 Fear and avoidance are powerful drivers of persistent pain.

2. MRI findings don’t predict pain or recovery

  • The severity of MRI changes does not correlate well with pain

  • People with “bad-looking” scans often do very well

  • People with “normal” scans can have severe pain

Pain is influenced by:

  • Load tolerance

  • Nervous system sensitivity

  • Beliefs and expectations

  • Stress, sleep, activity levels

MRI doesn’t measure any of this.

3. Imaging increases the risk of overtreatment

Studies show people who get early MRIs are:

  • More likely to be referred to surgeons

  • More likely to receive injections or surgery

  • Not more likely to have better outcomes

This is known as the imaging cascade.

When an MRI is appropriate (important)

Lumbar MRI is very useful and appropriate when there are red flags, such as:

  • Progressive neurological weakness

  • Suspected cauda equina symptoms

  • Significant trauma

  • Infection, fracture, cancer suspicion

  • Severe, persistent nerve pain not improving after appropriate care

In these cases, MRI improves outcomes by guiding necessary treatment.

So does an MRI harm you?

No — the scan itself does not harm you.

But how the information is interpreted and communicated can absolutely influence:

  • Your pain experience

  • Your confidence in movement

  • Your recovery trajectory

That’s where outcomes can worsen.

Practical takeaway

✔ MRI is a tool, not a diagnosis
✔ Most back pain improves with time and active management
✔ Imaging should support clinical reasoning — not replace it
✔ Understanding your scan properly matters more than the scan itself

Back pain doesn’t always need scans — it needs the right care. Book an appointment with Bacchus Marsh Physiotherapy today.

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