Do I Need a Scan for My Back Pain?

It feels logical: your back really hurts, so surely a scan will show what’s wrong. For most low back pain, though, imaging doesn’t change what happens next, and it can sometimes send people down the wrong path. Here’s a balanced look at when a scan helps and when it doesn’t.

Why scans usually aren’t needed

For ordinary low back pain without red-flag signs, national guidance in Australia and overseas recommends against routine imaging. There are good reasons:

• “Findings” are normal. Things like disc bulges and mild degeneration show up commonly in people with no pain at all, so a scan often finds changes that aren’t the cause of your symptoms.
• It rarely changes management. Most back pain is managed with movement, load management, hands-on care and time, whether or not you’ve had a scan.
• It can worry people unnecessarily. Alarming-sounding words on a report can make pain feel more threatening, which isn’t helpful for recovery.

When a scan is appropriate

Imaging is genuinely useful when there are specific signs that point to something needing different management. See your GP promptly for assessment (which may include a scan) if you have:

• Leg weakness or numbness that’s spreading
• Problems controlling your bladder or bowel, or numbness around the groin
• Back pain with unexplained weight loss, fever or feeling generally unwell
• A history of cancer, or significant trauma such as a serious fall or accident
• Pain that is severe, relentless and not settling at all

What to do instead

For most back pain, the evidence-based approach is to stay as active as you reasonably can, manage the load, and get guidance if it’s not settling. That’s exactly what an osteopathy appointment offers: a thorough assessment, a clear explanation, and a practical plan. If we ever think you need imaging or a GP review, we’ll tell you and help you get there. Read more about back and neck pain.

What an appointment for this involves

A detailed history and physical assessment, a plain-English explanation of what’s likely going on, and a plan built around your goals, with a sensible endpoint rather than open-ended visits.

References

• Choosing Wisely Australia: imaging for low back pain is often unnecessary.
• Better Health Channel (Victoria) on back pain self-management and when to seek help.

Not sure whether your back needs a look? Based in Glen Iris, you can book online and we’ll point you the right way.