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Low Back Pain: Do I Need an MRI or X-Ray Before Seeing a Physical Therapist?

This is a common question seen by people with low back pain and the answer is “no” for the vast majority. In many cases, most people believe imaging will help determine the source of their pain. However, imaging can be expensive and not have an impact on outcomes. Physical therapists can accurately diagnose your condition and address specific symptoms to relieve your pain and restore function without unnecessary imaging. If your physical therapist thinks x-rays or further imaging is necessary, they will recommend it and speak with your doctor about any concerns they may have.

Costs of Unnecessary ImagingLow Back Pain

It has been found that those who saw the doctor for low back pain and underwent an early MRI had higher health care utilization and increased medical costs compared to those who received physical therapy first. Consulting a physical therapist early can lead to decreased odds of using diagnostic imaging or future surgery for low back pain. Asymptomatic individuals often have positive imaging findings, such as that from normal disc degeneration from aging.

Questions you should ask yourself:

  • Will an image change the management of my low back pain?
  • Is the result of imaging just nice to know or do I need to know?

It’s Your Choice

Physical therapy is often very successful in managing low back pain and can help some people avoid unnecessary imaging. At TEAM Physical Therapy, our therapists are qualified to provide hands-on assessment of your condition, determine a diagnosis, and create a specialized treatment plan to restore your strength, function, and mobility.


This post was written by Joel Grafel. Joel is a third-year physical therapy student from the University of Nebraska Medicine Center. He is currently on a clinical rotation with TEAM physical therapist Nathan Scott at our Broken Bow location.