When is a CT or MRI truly necessary for low back pain?

Many people wonder: “Shouldn’t I get an MRI or CT scan to find out what’s wrong?”
However, the answer is not always straightforward, and in most cases this is not the first step.

Low back pain on its own does not justify a CT or MRI scan, even if a previous imaging study showed a disc abnormality or herniation.
A doctor primarily forms an assessment based on a detailed medical history and physical examination. Evaluating the symptoms together with the physical findings usually provides a clear direction on how to proceed. An X-ray is sufficient as an initial imaging test.

Without specific nerve-root symptoms, targeted therapy takes priority!

When is a CT or MRI indicated?

Imaging is needed when the symptoms and physical examination suggest that a disc protrusion or another abnormality may be compressing a nerve structure in a way that could lead to permanent damage.

In such cases, the patient is referred to a neurosurgeon, and if surgery is being considered, a targeted CT or MRI scan is essential.
The aim is to provide the operating surgeon with an accurate anatomical view of the surgical area.
This is the true medical reason for performing these imaging studies.

In all other cases, a CT scan results in unnecessary radiation exposure, and an MRI does not provide meaningful additional information for a conservative (non-surgical) treatment plan.

What can we do instead for low back pain?

The goal is always to reduce pain, restore freedom of movement, and improve quality of life.

Personalised thermal-water therapies and other physiotherapy treatments offer effective support in achieving these outcomes.

Advice

If you have low back pain, don’t start with imaging.
Instead, consult a specialist who will recommend the most appropriate and effective treatment based on your symptoms and clinical findings.