Dr Weston

Leg, Back Pain and the MRI

Added by on February 19th, 2013, filed under Dr Weston

Do you have chronic pain in your lower back or neck? Have you had a MRI or told you need one? Has someone told you surgery is your only option and the MRI confirms this finding?

MRI pic

It’s important to know that getting a MRI to evaluate short-term lumbar back discomfort is often misleading. Although MRIs can show you structural abnormalities, they are best at imaging for nerve discomfort. They can tell you what might be wrong but they cannot tell you where your pain is coming from.

“MRIs are best used to evaluate radiating leg pain, not necessarily lumbar back discomfort.”

The best way to evaluate lumbar back discomfort, in my opinion, is a careful physical examination and a series of diagnostic injections with local anesthetic to try to pinpoint exactly what structure hurts; ruling out muscular back discomfort first because it is most common in 95% of cases.

Surgery is probably justifiable if you have pain in your back that radiates down your leg, or pain in your neck that radiates down your arm. A MRI will confirm this because it can show structural conditions such as a skeletal narrowing (stenosis) that can be corrected surgically.

“In real estate it’s all about location, location, location. For surgical outcomes it is patient selection, patient selection, “unbiased” patient selection.”

The right patient with the right problems and performing the right surgery well on them is the only way to a good outcome.

What do you think?