--- title: "Do I Need a Scan for My Back Pain? | Healthflex" description: "When an MRI genuinely helps back pain and when it does not, why scans find things that do not hurt, and the symptoms that need seeing today." canonical: "https://healthflex.co.uk/blog/do-i-need-a-scan-for-back-pain" last_updated: "2026-09-17T12:13:54.256Z" --- # Do I need a scan for my back pain? ![Martin Dyer, physiotherapist and director of Healthflex in Haslemere Description: Head and shoulders portrait of Martin Dyer, physiotherapist and director of Healthflex, The Edge, Haslemere. He has swept back dark hair greying at the sides and a warm, closed mouth smile, and wears a pale pink striped shirt with a pink and blue striped tie. The background is a blurred garden of autumn shrubs and trees.](/_next/image?url=%2Fapi%2Fmedia%2Ffile%2Fhealthflex-martin-dyer-physiotherapist-director-haslemere-64x79.jpg%3Fprefix%3Dtenants%252F6a993819fabdf5583928bbf1%26v%3D1790158917409&w=128&q=75&dpl=dpl_FWxsgCyzDSRxWHosZK98qVgRxgBw) Martin DyerPhysiotherapist and Director PublishedThursday, 10 September 2026 ![Practitioner pressing another person’s lower back and hip while they lie on their side on a grey table](/_next/image?url=%2Fapi%2Fmedia%2Ffile%2Fhealthflex-back-and-neck-physiotherapy-1.jpg%3Fprefix%3Dtenants%252F6a993819fabdf5583928bbf1%26v%3D1790157217392&w=2560&q=75&dpl=dpl_FWxsgCyzDSRxWHosZK98qVgRxgBw) It is one of the first things people ask us, usually within a minute of sitting down. My back has been like this for six weeks, should I be getting a scan? It is a completely reasonable question. Something hurts, nobody has told you why, and a scan feels like the way to find out. The honest answer is that for most back pain, an MRI will not help you and may set you back. That is not a cost saving argument and it is not us being unhelpful. It is what the evidence says, and it is worth understanding why. ## Scans find things that were never hurting The uncomfortable truth about spines is that they look worn on film long before they feel worn, and often when they feel nothing at all. When researchers have scanned large numbers of people with no back pain whatsoever, they have consistently found disc degeneration, disc bulges and other changes in a substantial proportion of them. Roughly a third of pain free people in their twenties already show disc degeneration, and by the eighties it is present in the overwhelming majority of people who have no symptoms at all. Those findings accumulate quietly with age in the same way grey hair does. So if we scan your back, we will very probably find something. The problem is that we then have no way of knowing whether what we found is causing your pain or whether it has been sitting there harmlessly since you were thirty. A report describing degeneration, wear or a bulging disc is describing a normal ageing spine, not an injury. ## Why an early scan can make things worse This is the part that surprises people most. Having an MRI early for ordinary back pain is associated with worse outcomes, not better ones. People who are scanned early tend to have more treatment, more injections and more surgery, and they do not end up in less pain for it. The reason is largely about what the words on the report do to you. Being told you have degeneration and a bulging disc at forty two is frightening, and fear changes how people move. They guard the area, they stop lifting, they stop exercising, they start describing themselves as having a bad back, and every one of those responses makes recovery slower. We spend a good deal of time undoing the damage a poorly explained scan report has done. This is why [NICE guidance on low back pain and sciatica](/services/lower-back-pain) advises against routine imaging in non-specialist settings, and says a scan should only be considered where the result would actually change what happens next. ## When a scan genuinely does help There are real reasons to image a back, and we will arrange or recommend one without hesitation when they apply. A scan is appropriate when there is a suspicion of something serious rather than mechanical, when there is nerve compression that is getting worse rather than better, when symptoms have not responded to a properly delivered course of treatment and a surgical or specialist opinion is now on the table, and when a specific injury makes a fracture plausible. The distinction is simple. If knowing what is on the film would change the plan, the scan is worth having. If the plan is the same either way, which for most back pain it is, then the scan adds anxiety and cost and nothing else. ## The symptoms that need seeing today There is a small group of symptoms that are not about scans at all. They are about being seen urgently. Numbness in the saddle area, between your legs or around your back passage. Difficulty passing urine, or not being able to feel when you need to. Loss of control of your bowels. Weakness in both legs. Back pain with a fever, or alongside unexplained weight loss. If you have any of those, do not book a physiotherapy appointment and do not wait for a scan. Contact your GP the same day or go to hospital. If you describe them to us, that is exactly where we will send you. ## What we do instead A good assessment answers most of what a scan would, and answers the parts that matter more. We take a proper history, because when the pain started, what makes it worse and what you have already tried usually points at the cause more reliably than an image does. We examine how you move, test your strength and check your nerves. From that we can tell you what we think is driving the pain, whether it is the sort of problem that needs a doctor rather than us, and what treatment involves. If your pain travels down your leg, [sciatica](/services/sciatica) behaves differently from ordinary back pain and we will say so. If somebody has already mentioned a disc, our page on [disc injury](/services/disc-injury) explains what that does and does not mean. Then the work begins, and it is mostly [treatment and a graded exercise programme](/services/back-and-neck-physiotherapy) rather than anything mysterious. NICE recommends staying as active as you can manage, which is the opposite of what instinct suggests when something hurts. ## The short version Most back pain does not need a scan. Most scans of most backs will find something, and that something is usually not the problem. The exceptions are real but uncommon, and the symptoms that genuinely need urgent attention are listed above and are worth knowing. If your back has been bothering you and nobody has explained why, an assessment is the more useful place to start. Our page on [what happens at a first appointment](/your-first-visit) sets out exactly what that involves, or ring us on 01428 642577 and describe it and we will tell you honestly whether we are the right people. Keep reading ## Related articles [All articles](/blog) [ ![Black open-patella knee brace with Velcro straps on bare leg](/_next/image?url=%2Fapi%2Fmedia%2Ffile%2Fhealth-flex-knee-bracejpg%3Fprefix%3Dtenants%252F6a993819fabdf5583928bbf1%26v%3D1790165106186&w=3840&q=75&dpl=dpl_FWxsgCyzDSRxWHosZK98qVgRxgBw) Pain and injury explained · 5 min ### Do I need a knee brace? 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