08/29/2026
It’s commonly believed that x-rays and MRIs can determine the exact cause of low back pain and how to fix it, but imaging does not change management or improve outcomes in the majority of cases. For that reason, and this might be very surprising, x-rays and MRIs are not recommended for most instances of low back pain.
Here are 3 things to consider:
1. Degeneration, disc bulges, and other similar findings are common in asymptomatic individuals and should be considered a normal part of aging like wrinkling of your skin or graying of your hair. For example, despite having no symptoms, 37% of 20-year-olds demonstrate disc degeneration, while 96% of 80-year-olds show the same. This holds true for many cases of spinal stenosis, spondylolisthesis, and disc herniations. This is why a person’s history and presentation are so important.
2. The degree of change on imaging doesn’t always correlate with a person’s symptoms or function. For instance, a larger disc herniation or more compression of a nerve doesn’t necessarily mean worse symptoms or outcomes. In fact, it’s possible to have compression of a nerve with no symptoms at all. Rehab doesn’t usually have to focus on the image because the image doesn’t have to change, and often doesn’t change, for symptoms and function to improve.
3. Imaging costs more money, can create unnecessary worry, and may actually lead to worse outcomes if it results in further medical tests and treatments that are unwarranted (Webster 2013, 2014)
Does that mean imaging is never required? No. Imaging may be necessary if a fracture, infection, inflammatory disease, or cancer is suspected, or if you’re considering surgery at the recommendation of your doctor. This is a discussion to be had with your medical doctor.
Don’t get me wrong, diagnoses and imaging findings are helpful in the right context, but sometimes labels can negatively influence expectations and create self-limiting beliefs. I just want you to know that you’re more than a diagnosis or imaging finding. You’re not defined by a label.
To learn more, click the link in our bio or search “E3 Rehab Low Back Pain” on YouTube!
