Do you need a MRI before trying Physical Therapy?

By: Zach Ball, PT, DPT, OCS, Regional Manager at ApexNetwork Physical Therapy
Many clients feel that they need to have an MRI before trying Physical Therapy. This is largely driven by our need for answers: we want to know what is causing our pain and how to treat it. Often, patients come to our clinic frustrated because their insurance required them to try Physical Therapy before a MRI will be approved. Let’s discuss when MRI’s are necessary, why the vast majority of the time MRI’s are not necessary, and what PT can do to help.
MRI’s are primarily warranted when a more serious medical condition is suspected due to “red flag” signs or symptoms. Furthermore MRI’s are very good at showing the anatomical structures, but are not as reliable at identifying exactly what is causing your pain. Multiple research studies have been performed showing over 50% of people with no back pain have a disc herniation on MRI scans.
At ApexNetwork Physical Therapy, we schedule a full hour 1-on-1 for our initial evaluation visits to ensure your Physical Therapist has time to fully evaluate you to look for what is causing your pain. We will perform a comprehensive clinical examination including range of motion and strength assessment, reflex and sensory screen, posture assessment, and special tests to look for sprains/strains/tears/altered movement patterns that can contribute to your pain. Physical Therapists are highly trained to continually monitor your medical status and look for any “red flag” symptoms and will communicate with your doctor if further testing or imaging is warranted.
In summary MRI’s are costly, delay treatment, and in the vast majority of cases do not alter the course of treatment. Physical Therapists are highly trained practitioners that can safely evaluate and treat your symptoms, and look for any signs that warrant further medical testing or imaging. Get on the road to recovery. Contact an ApexNetwork Physical Therapy location near you to get started with treatment, decrease your pain and improve your functional abilities.
 
References:
Jensen MC, et al. “MRI imaging of the lumbar spine in people without back pain.” N Engl J Med 1994; 331:369-373
Boden SD et al. “Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects: A prospective investigation.” J Bone Joint Surg Am 1990; 72A:403-408