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Dr. Carri Dominick, PT, CSCS

Why Do I Need an MRI?


As we have already discussed getting an MRI costs more money than getting treatment for your pain or injury. As cited in my previous blogs, research shows surgery is no better than non-surgical treatment for many conditions such as knee pain, rotator cuff tear and back pain. So, if I probably don’t need surgery and an MRI is going to cost me more money, than why do I need one?

What do you expect to find from getting an MRI? This is not a rhetorical question. You need to seriously ask yourself this question before going to get an MRI. Let’s take a step back here for a minute and discuss why the doctor wants you to get an MRI. We all (doctors and patients) know that an MRI is an expensive test, however it is frequently recommended. This is likely because doctors want to cover all their bases in order not to get sued for malpractice or neglect in today’s sue-happy America that we live in. Doctors know that majority of the time they are not going to find anything serious when they have a patient get an MRI. Although some doctors, especially orthopedic doctors and chiropractors, still want their patients to get an MRI expecting to find torn muscles or bulging discs. Your primary care physician is likely just covering themselves from getting sued because there is nothing they are going to do to fix your torn rotator cuff or bulging lumbar disc.

The next question would be: what if it is something more serious? Shouldn’t I get an MRI just to be sure. The likelihood of finding out you have cancer or a tumor or something else life threatening because your back or shoulder or knees hurt is a very small possibility. Something like 3%. Yes, I have had patients who had an MRI and found out they had a tumor even though they had no other symptoms. This is rare. I can think of 2 patients in my 10 years of being a physical therapist. Likely if you have something serious like cancer you are going to have symptoms other than pain when you walk, for example. Any healthcare provider who is really listening to your story should be able to pick out these symptoms that don’t sound like a torn tendon. A few examples, but not an exhaustive list (please do not take this as a replacement for medical advice) are night pain and night sweats, pain that doesn’t change with position changes, unexplained weight loss or weight gain, etc. If your shoulder hurts when you reach for something, that is probably muscle or tendon pain that a physical therapist can fix. If your back hurts after sitting at your desk for 4 hours straight, that is muscle pain that a little exercise can fix. If you wake up in the night sweating and in pain, but you don’t have pain during your day to day activities, that might be something more serious that you should have checked out by your doctor. Just a few examples.

What if I think I broke a bone? Then you should get an x-ray. That is the best test to show a broken bone. An MRI shows more muscles, tendons and ligaments, but doesn't show bones as well. An x-ray is cheap and easy and highly recommended if you think you broke a bone.

Back to the original question, why do I need an MRI? The answer is, you probably don’t. Unless you have pain that is unrelated to movement. If your pain is related to movement or certain positions, then see your physical therapist first and skip the MRI, skip the doctor visit and save yourself time and money. Fix the cause of the problem without medication. Contact me to set up an assessment to see if physical therapy can help with your pain without needing to get an MRI first.

*None of the information in this article is meant to be substituted for individual medical advice. If you have questions please contact me at rechargetherapylbc@gmail.com or visit my website for more information.

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