Are MRIs and X-rays enough to diagnose the cause of back pain?

It is common for most doctors to advise imaging tests like MRI or X-ray to determine the cause of back pain. These are useful if your problem is due to a structural issue in the spine. But, most back pain cases are mechanical in nature. In such cases, imaging tests like MRI & X-rays fail to show you the complete picture.

MRI & X-ray images cannot distinguish between subtypes of back pain and chronic issues. MRI findings do not match with intensity of pain and disability in case of discogenic back pain. Interpretive errors by radiologists make these reports extremely subjective which, can directly impact the diagnosis, treatment and clinical outcomes. These are only a few of the many shortcomings of referring to imaging tests as the primary mode of diagnosis.

The good news is, that researchers from Germany have made advances in developing very accurate spine function tests which are now being used extensively by leading physicians and orthopaedics.

“New technological advances in back pain diagnosis has helped us jointly build a path to non-surgical treatment of back and neck pain. This can help us approach the problem with a more holistic view. This is certainly changing the face of back pain treatment in India,” shares Dr Gautam Shetty, Senior Orthopaedic Surgeon, Mumbai.

Why imaging tests show an incomplete picture

One of the most common causes of back pain is mechanical back pain, which is caused by weak musculature and cannot be seen in an X-ray or MRI. These are standard imaging tests, which focus on studying the structure of the spine. They do not adequately diagnose the condition of degenerated tissues. This is why, most back pain cases are classified as ‘non- specific’ by the doctors.

“These tests study the patient's condition in a static position. But, patients often experience pain when they perform a certain task like – bending, walking or sitting. This is why many doctors recommend a Spine Function Test to show a more complete picture. A spine function test can help identify the weak areas of the musculature and help doctors develop a more targeted treatment plan. It has helped us prevent many unwarranted surgeries,” says Dr. Garima Anandani, Clinical Director, QI Spine Clinic.

How a Spine Function Test can help

A Spine Function Test can reveal weaknesses in the patient’s spine and isolate the affected area and the movements, which cause the pain. This enables doctors to focus on the affected area with targeted treatment.

The Digital Spine Analysis (DSA) is a gold standard in Spine Function Testing and is accepted by doctors worldwide. It is more accurate because it performs a functional analysis of the spine. The mechanical structure of the back is monitored on different motion sensitive devices across parameters like - strength, mobility, and balance, to identify the muscle groups which are causing pain.

This helps the spine specialists prescribe a tailor-made spine rehabilitation programme can even prevent surgery in some cases.

“The most common form of back pain comes from mechanical wear and tear of the support tissues of the spine. A Spine Function test can individualise your problem and help develop a need-based rehabilitation programme. This seems to be the future of back pain cure,” says Dr Abhay Nene, eminent Spine Surgeon.