Why Getting an MRI for Back Pain Isn’t Always a Good Thing

It’s natural to think that getting an MRI will “show exactly what’s wrong. But for most cases of back pain, an MRI doesn’t help recovery—and in many cases, it can actually make things worse.

Here’s why:

1. MRI Findings Often Look Scary but Are Completely Normal

Research has shown that many people with NO back pain at all have:

• Disc bulges

• Disc protrusions

• Degeneration

• “Wear and tear”

• Arthritic changes

These findings increase with age and are considered normal age-related changes, just like wrinkles or grey hair.

Studies show:

• 50–60% of people in their 40s with no pain have disc bulges

• Up to 80% of people in their 50s–60s have disc degeneration without symptoms

• Even people in their 20s often show “abnormalities” on MRI that cause zero pain

So an MRI often shows things that look serious but aren’t the cause of your pain.

2. MRI Findings Do Not Predict Your Level of Pain

A disc bulge on MRI does NOT mean:

• You will have severe pain

• You need surgery

• Your spine is damaged

• Your pain won’t get better

In fact, your pain often improves long before MRI findings change. MRI images show anatomy, not pain.

3. Scary Words Create Fear — Fear Creates More Pain

When people see terms like “degeneration,” “bulge,” “protrusion,” “tear,” or “narrowing,” it often causes:

• Fear

• Worry

• Avoidance of movement

• Higher pain levels

This is called nocebo—the opposite of placebo. Unnecessary imaging can actually slow your recovery because it increases worry.

4. Most Back Pain Improves Without Imaging

The vast majority of back pain episodes improve with:

• Modified activity

• Physiotherapy

• Movement advice

• Time

Scans are only recommended if there are red flags, such as:

• Severe or worsening nerve symptoms

• Loss of bowel/bladder control

• Significant weakness

• Trauma

• Signs of serious underlying disease (very rare)

If you don’t have these, an MRI usually doesn’t change treatment at all.

5. MRI Can Lead to Unnecessary Procedures

Once something is found on MRI—whether it’s the source of pain or not—patients often feel

pressured into:

• Injections

• More scans

• Specialist appointments

• Even surgery

Many of these are not needed and do not improve long-term outcomes.

The Bottom Line

MRI is a powerful tool when used at the right time.

But for most people with back pain:

• MRI does not explain the pain

• MRI does not speed up recovery

• MRI often finds normal, age-related changes

• MRI can create unnecessary worry

Your symptoms, movement patterns, and response to treatment tell us far more than a picture.