Why you don’t need an MRI and what you should do instead.
If you suffer with lower back pain and/or pain radiating into your legs and feet (also known as sciatica), you are probably spending a lot of time thinking about what is going on inside the structures of your lower back and you probably have had, or think, that you may need an MRI or other scans.
That’s not the case in most situations. In fact an MRI could cause more problems than it could solve, mainly by causing unnecessary fear and worrying regarding your lower back or by leading to surgery that isn’t actually needed.
A review of the scientific literature shows that MRI results such as bulging and degenerating discs are actually extremely common in people who have absolutely no lower back pain or sciatica.
This does not mean that your pain is not real; it most certainly is! It just shows that many people walk around everyday blissfully unaware that they have these abnormalities; in fact they are so common that the word abnormality is very misleading and can cause a lot of harm on a psychological level.
So what is causing your pain?
A lot of the time it cannot be known for sure what exact structure is causing the pain but there are many other structures and tissues in the lower back that can be pain generators.
Pain generators could be:
- Facet joints degeneration;
- Muscle tightness;
- Muscle weakness;
- Decreased activity levels;
- Carrying too much body weight;
- Referred from the hip.
There are many things that can cause lower back pain. The great majority, are harmless and nothing to worry too much about.
What can you do to help yourself?
1) The best possible thing you can do to help yourself is to keep as active as possible and not be afraid to move even though your back is hurting. Bed rest and avoidance of general movement is going to make your back much stiffer and more painful in the long run. Keep moving but move gently and as normally as possible.
2) See your GP and ask to be advised on some pain medication to take in the short term to help you get through the initial muscle spasms.
3) Repeat step 1 until the pain eases and then gently increase your physical activity. Find a sport or active pursuit that you enjoy and do this 3-4 days a week. This will help keep the back strong and supple.
Good forms of exercise are walking, jogging, cycling, swimming, yoga, Pilates, hiking, football, climbing, gardening… the list is endless. The important thing is finding an exercise you enjoy and sticking to it.
If after a couple of weeks the pain hasn’t passed or become more manageable, book in to see one of our physiotherapists or osteopaths at Woodside Clinic, who are all fully trained in assessing and treating lower back pain. They will aim to figure out the root cause of your pain and treat it appropriately.
When should you worry?
Times you should worry include:
- Pain that is constant, ALWAYS THERE, and getting worse, no matter what you do (time to see the GP);
- Loss of ability to control your bowel or bladder (seek immediate medical attention!);
- Weak urine stream;
- Loss of sensation in your private areas;
- Loss of sexual function (inability to get an erection);
- Inability to walk properly due to weakness in the legs.
If you have noticed any of these symptoms (especially if they started at the same time as your lower back and sciatic symptoms) then it is recommended that you visit your doctor as soon as possible.