Ask Aviva #16: Why won’t my doctor do an MRI for my back pain?

Dear Aviva,

I am 53 years old, have played a lot of sports and have had back pain, on and off, for about 10 years. Unfortunately, it’s gotten a lot worse recently. I would like an MRI to find out what is going on. However, my family doctor says that because I don’t have any leg weakness or numbness, I don’t need this. Is this negligence?! Is she just trying to save the system money? What if I have a tumor in my spine? And she told me to resume my regular work and exercise schedule! Should I change doctors?


Pain in Bat Yam


Dear Pain in the Bat,

First off, you should stay with your family doctor, as she has obviously internalized the international standards of Non-Specific Lower Back Pain (NSLBP), which strongly suggest that little or no imaging or invasive procedures be conducted for LBP that is not associated with numbness or weakness.

The recommendations are to prescribe physical therapy, moderate exercise, and regular work routines. Years of data and research has demonstrated that MRIs and other testing leads to overtreatment, increased surgery and no real reduction in pain or functioning. This is definitely the case of less is better. Instead, seek out a physical therapist, or recommended chiropractor who specializes in LBP. And check out my blog post from last year.

Yours in health,


Ask Aviva #15: What do I do if my doctor won’t send me for a second opinion?

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