Should I Get an Xray or MRI for my pain?

January 25th, 2021

After experiencing an injury, many people ask themselves the question, “Should I have an X-ray or MRI before I come to therapy?” 

What should I do? 

Well, our intuition would typically say “I have back pain, therefore an x-ray or MRI will help me determine what’s wrong and how to go about fixing it.”  We must know the medical diagnosis before we can go about treating a condition, right?  Although this is a fairly common and reasonable view, imaging reports associated with physical pain, especially when the pain has lasted for a long time, provide limited information to determine appropriate treatment strategies and likelihood of recovery. 

There are important situations where your physician may order an x-ray or MRI prior to referring you to physical therapy.  This may be to determine the nature of a recent injury or a serious medical condition if suspected.  In other cases, you may come directly to physical therapy and the physical therapist will refer you to your physician for this same reason. 

So if you begin physical therapy without having an X-ray or MRI first, this is often because your physician or other qualified health professional has determined that you are likely to recover without costing you the time and financial burden of an imaging study. 

What do my results mean? 

It is rare that an imaging report is completely normal or unremarkable.  Most people have some degree of degeneration, disc protrusion, bone spurs, and other findings.  It is important to understand that many individuals can be pain free yet display abnormal findings on an imaging report.  There are many people who have varying ranges of pain and do not show associated findings on an X-ray or MRI report.  So the presence of arthritis, rotator cuff tears or disc protrusions and many other findings require further context to determine their significance. 

As health professionals have advanced in our understanding of treating pain and physical injury, we have learned that there are many factors that come into play when finding the “root cause.” These have more to do with health factors, mobility, and physical limitation than they do with pure findings on an imaging report.  These are the findings resulting from a thorough exam performed by a physical therapist. 

Physical therapists are the function and movement experts.  This means that physical therapists are committed to helping you regain your mobility, strength, and improve your overall physical health to live your life to the fullest.   Whether that be picking up your grandchildren or returning to a sport you love, a physical therapist’s primary goal is to help you achieve an optimal quality of life.