Do I Need an MRI?

The MRI (Magnetic Resonance Imaging) was developed in the 1980’s and has been used since that time to diagnose and treat back pain. The MRI is considered to be the single best imaging technique to determine the cause of back pain and to develop a treatment plan. MRI’s provide a detailed image of the spinal anatomy, including the anatomy of discs, nerve roots, and bony structures.

MRI scans are useful for:

• Assessing the health of the intervertebral discs
• Revealing fractures not seen on x-rays or CT scans
• Diagnosing tumors or infection in the spine
• Diagnosing disc herniations and nerve impingement
• Assessing the success of a surgical intervention

An MRI works by rotating a magnet around the patient which causes a reaction in the hydrogen atoms in the body. The hydrogen atoms emit a small amount of radiation that is recorded in the form of an image.

While an MRI can be useful in diagnosing a cause for back pain and developing a treatment plan, results of an MRI should not be read in isolation, but should be viewed as part of the patient’s entire medical situation. For instance, an “abnormality” that is revealed on an MRI does not always pinpoint the problem. Studies have shown that approximately 30% of the general population have an MRI-indicated disc abnormality, but no back pain.

MRI results should be correlated with a patient’s symptoms, including duration, location, and severity of pain, and any neurological deficits on physical examination.

An MRI of the spine is usually indicated in the following situations, although you and your doctor should make all treatment decisions:

• After 4 to 6 weeks of leg pain, if the pain is severe.
• After 3 to 6 months of the low back pain, if the pain is severe.
• If the back pain is accompanied by constitutional symptoms (such as loss of appetite, weight loss, fever, chills, shakes, or severe pain) which may indicate a spinal tumor or infection.
• For patients who are considering an epidural injection.
• For patients who do not experience expected improvement following spinal surgery.

If an individual is experiencing bowel or bladder incontinence or progressive weakness in the legs due to nerve damage, usually an MRI should be ordered immediately.

Workers’ compensation insurance companies very commonly refuse to approve an MRI that’s been ordered for an injured worker, whether it is to diagnose a suspected herniation, or to assess a patient’s improvement after a course of conservative care, or in anticipation of surgery. Don’t ignore disputes with the workers’ compensation insurance company!

If you’re having difficulty getting the medical treatment you need for your work injury, or to learn more about your Minnesota workers’ compensation rights, contact Meuser & Associates at 877-746-5680, or click here to send us an email.