"Back pain is a common issue, with millions of Americans experiencing everything from a simple backache to more serious back injuries," says Bryan "Keith" Morrison, MD, Family Medicine at ARC Cedar Park Building C. "However, when you visit the doctor with back pain, we often don't recommend imaging (like X-rays or MRIs) right away."
Diagnosing back pain
Doctors rely on a patient's medical and family history and a physical exam to initially diagnose the cause of back pain. Whether it's a back injury, chronic pain, or constant pain that won't go away, we start by asking key questions like:
- Where is the pain located?
- When did it start, and what makes it better or worse?
- Does your family have a history of back problems?
The physical exam helps us understand your posture, muscle strength, and how your movement affects the pain. Your doctor may ask you to rate your pain on a scale from 1 to 10 to gauge the severity of the pain and talk to you about your ability to perform activities of daily living.
Why not start with imaging?
Imaging, like MRIs and CT scans, has its place, but it's not always the best first step for back pain. Here's why:
- Hidden causes: Many back problems, like muscle strain, don't show up on scans.
- Misleading results: Abnormalities, like bulging discs, are common—even in people without pain. This can lead to unnecessary worry or treatment.
- Back pain is complex: Stress, sleep, and mental health can all play a role in how we experience pain—factors that imaging can't reveal.
- Evidence-based approach: Conservative back pain treatments like physical therapy, exercise, medication, anti-inflammatories, and sometimes mental health support often provide better outcomes, even for chronic or constant pain.
When is imaging needed?
In most cases, your doctor can determine the cause of your back pain through a careful discussion of your symptoms and a physical exam. Early imaging, especially in adults, often leads to treatments that may not provide real relief and can even make things more complicated.
However, if your pain continues for more than six weeks despite trying other treatments, imaging may be the next step to help understand what's going on. If you have back pain along with these symptoms, tell your doctor:
- Unexplained weight loss
- High fever
- Loss of bladder or bowel control
- Numbness or weakness in your legs
- History of cancer
These could be signs of more serious conditions like infections or nerve damage, and imaging can help diagnose them.
"While imaging can be helpful, it's not always necessary for diagnosing back pain," says Dr. Morrison. "Trust your doctor's approach, which focuses on understanding your pain through history, physical exams, and conservative treatments before considering scans."
About ARC in Cedar Park
There are three ARC clinics located in Cedar Park. ARC Cedar Park Building B and ARC Medical Plaza Specialty offer 12 different specialties, and ARC Cedar Park Building C offers primary care and After Hours Care. Our specialties range from Allergy and Asthma to Sports Medicine; our primary care physicians and APCs include Family Medicine, Internal Medicine, and Pediatrics.
Make an appointment today
To make an appointment with an ARC Family Medicine physician or APC at ARC Cedar Park Building C, schedule online through ARC MyChart or call 512-259-3467.