Do I Need an MRI for Back Pain? A Roanoke Chiropractor’s Perspective

If you’re dealing with back pain in Roanoke, VA, one of the most common questions is: “Do I need an MRI?” Many people assume imaging is the first step toward a solution, but in most cases, it’s not necessary — and sometimes it doesn’t change treatment at all.

Understanding when imaging is helpful (and when it isn’t) can save you time, money, and unnecessary stress.

When Imaging Is Necessary

An MRI can be extremely useful in specific situations. Imaging is typically recommended when back pain is accompanied by red flags, such as:

• Progressive neurological symptoms (worsening weakness, numbness, or loss of coordination)
• Loss of bowel or bladder control
• Severe trauma (car accidents, significant falls)
• Suspected infection, fracture, or tumor
• Pain that does not improve after a reasonable trial of conservative care

In these cases, imaging helps guide medical decision-making and ensures more serious conditions are ruled out.

When MRIs Don’t Change Treatment

For most cases of mechanical low back pain, MRIs are often unnecessary early on.

Research shows that many MRI findings — such as disc bulges, degeneration, and arthritis — are common even in people with no pain at all. These findings can sound alarming, but they don’t always explain symptoms or predict outcomes.

In many cases:

• Treatment remains conservative regardless of MRI findings
• Imaging can increase fear and anxiety
• Patients may delay helpful care while waiting for scans

That’s why most clinical guidelines recommend starting with conservative care unless red flags are present.

Conservative Care Options in Roanoke

Conservative care focuses on restoring movement, reducing irritation, and improving strength — without injections or surgery.

Common conservative options include:

• Chiropractic care
• Targeted rehabilitation exercises
• Soft tissue therapy
• Activity modification and education

These approaches are often effective for both acute and chronic back pain and carry far fewer risks than invasive procedures.

How Chiropractic Care Helps Back Pain

At Highland Spine + Sport, we take an evidence-based, movement-focused approach to treating back pain in Roanoke, VA.

Our care typically includes:

• A thorough movement and neurological assessment
• Chiropractic adjustments to restore joint motion
• Soft tissue therapy to reduce muscle tension and guarding
• Progressive exercise to build strength and resilience
• Education to help you understand your pain and move confidently

The goal is not just pain relief, but long-term improvement and prevention of future flare-ups.

You Don’t Always Need an MRI to Get Better

Most back pain improves with the right conservative care. Imaging has its place, but it isn’t always the first or best step.

If you’re unsure whether an MRI is necessary, a comprehensive evaluation can help determine the most appropriate next step.

At Highland Spine + Sport, we help patients in Roanoke make informed, confident decisions about their care.

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