Do I Need an MRI for Low Back Pain? What Most People Don’t Know

If you’re dealing with low back pain, it’s common to wonder whether you need an MRI to figure out what’s going on. Imaging feels like the logical next step, especially if pain has been lingering or flared up unexpectedly. But for most people, an MRI is not necessary right away.

At Momentum Spine and Sport in Orange City, FL, we see this all the time. Many patients assume imaging is required to diagnose their back pain, but research shows that MRI findings like disc bulges, disc degeneration, and even herniations are often present in people without any pain at all. These changes are frequently a normal part of aging and do not always explain symptoms. Pain does not automatically mean damage.

Ordering imaging too early can actually create problems. MRI reports often include language that sounds alarming and can increase fear, lead to unnecessary restrictions, or push people toward treatments they do not need. We regularly work with patients who were told their back was damaged based on imaging, only to find that movement and proper rehabilitation were what truly helped them recover.

There are times when an MRI is appropriate. Progressive neurological weakness, changes in bowel or bladder control, significant trauma, or symptoms that do not improve with appropriate conservative care may warrant imaging. In those cases, an MRI can help rule out more serious conditions and guide next steps.

For most cases of low back pain and sciatica, function matters more than imaging. How you move, how your body tolerates load, and how confident you feel using your back often tell us far more than a scan alone. That is why our approach focuses on movement assessment, symptom behavior, and gradual progression rather than relying on imaging as the starting point.

The goal is not just short term relief. It is helping you understand your pain, move with confidence, and build long term resilience. If you are unsure whether an MRI is necessary, or you already have imaging and still feel stuck, we can help you make sense of it and determine what to do next.