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Line Dragsbæk¹, Tue Secher Jensen^2,3, Bodil Arnbak^3,4

¹Afdeling for Anvendt Sundhedsforskning, UCL Erhvervsakademi og Professionshøjskole.

Ugeskrift for Laeger

|March 9, 2023

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Magnetic resonance imaging (MRI) for low back pain (LBP) shows common degenerative findings, but these results lack prognostic value. Current evidence suggests MRI should not guide treatment decisions for LBP.

Area of Science:

Orthopedics
Radiology
Pain Management

Background:

Magnetic resonance imaging (MRI) is frequently utilized in diagnosing low back pain (LBP).
Degenerative changes in the lumbar spine are common findings on MRI scans.
The clinical significance and prognostic value of these degenerative findings in LBP remain areas of active investigation.

Approach:

This review synthesizes current evidence on the clinical relevance of degenerative findings on lumbar spine MRI.
It examines the association between MRI findings and LBP at both population and individual levels.
The prognostic implications of these findings for treatment outcomes are critically evaluated.

Key Points:

A consistent association exists between degenerative MRI findings and LBP at the population level.

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However, research on the prognostic value of these findings is limited.

Current evidence does not support using MRI findings to guide specific treatment strategies for LBP.

Conclusions:

Lumbar spine MRI is a valuable tool for identifying specific pathologies or progressive neurological deficits.
It is recommended only when conservative treatment fails to yield progress or in cases of suspected serious conditions.
MRI findings alone are insufficient to direct treatment for most low back pain cases.