Is magnetic resonance imaging necessary for every patient with low back pain?

Aim: The aim of this study is to evaluate lumbar magnetic resonance imaging findings in patients with low back pain to reveal the relationship between clinical pain and magnetic resonance imaging findings. Material and Methods: This was a retrospective study. For all participants, age, gender, visual analog scale (VAS) score, and magnetic resonance imaging findings were recorded. Participants were divided into 2 groups according to magnetic resonance imaging results, with normal magnetic resonance imaging findings in Group 1 and pathological findings in Group 2. Gender, age, and visual analog scale scores were compared between groups. In addition, magnetic resonance imaging pathologies were grouped by number of patients, age, gender, and visual analog scale score. The most common magnetic resonance imaging findings and accompanying clinical data were reviewed. Results: Mean visual analog scale scores were found to be 5.5 +/- 1.70 and 7 +/- 1.56 with no statistically significant difference between Group 1 and Group 2, respectively (p=0.055). The number of patients with a single magnetic resonance imaging finding was 90. Among these, bulging was the most common with 54 patients; among these patients, the mean age and visual analog scale scores were lower. Patients with canal stenosis and spondylosis had higher ages and visual analog scale scores. Coexistence of flattening and bulging in 20 (8.3%) patients and the association of protrusion, flattening, and spondylosis in 20 (8.3%) patients represented the most common combinations of multiple magnetic resonance imaging findings. Discussion: Magnetic resonance imaging does not usually alter clinical results in cases of low back pain without serious underlying symptoms. Routine lumbar magnetic resonance imaging should be avoided in patients with acute or subacute low back pain without symptoms suggestive of a serious underlying condition.