Fixing Back Pain: Can a Lumbar Spine MRI Help?

As we age, back pain seems to become just a part of life. It’s estimated that 80 per cent of adults in the UK will suffer from lower back pain. It's one of the largest contributors to missed workdays. Not only can back pain affect your ability to work, but it can also wreak havoc on your everyday life. Putting away groceries, playing with your kids, even getting out of bed can become a challenge. It's annoying and not knowing the cause can be even more frustrating.

Your back pain could be muscular, the result of a pinched nerve, or an even more serious spinal condition. The only way to know for sure is through an MRI of the lumbar spine. This diagnostic procedure can rule out any potentially serious spinal issues and can help you get back to living a pain-free life.

Opting to have a lumbar MRI can be nerve-wracking for some people, and accepting your back pain is serious enough to undergo this procedure can bring up feelings of anxiety. But finding out if there is a bigger issue at play is the first step in your potential recovery process. If you have been experiencing lower back pain and are considering an MRI scan, following along as we discuss what to expect from the procedure.

What is Your Lumbar Spine?

The lumbar spine refers to the last five vertebrae between your ribs and your pelvis. The vertebrae are referred to as:

• L1
• L2
• L3
• L4
• L5

These vertebrae are larger compared to the rest of your spine. This is because they are designed to absorb more shock. The vertebrae also protect your spinal cord and nerves. Between the L1 and L2 vertebrae, the spinal cord ends and tapers into the conus medullaris. Nerves from the lower trunk feed into this structure, then into your spinal cord, and finally to your brain stem. Each vertebra is separated by a cartilage ring called an intervertebral disc, usually referred to as a disc.

If any of these structures are damaged or have an abnormality, they can cause lower back pain.

What Do You See in a Lumbar MRI?

A lumbar magnetic resonance imaging (MRI) scan will be able to show doctors several structures including,

• Vertebrae
• Intervertebral Discs
• Nerves
• Surrounding Muscles
• Additional Soft Tissues

An MRI takes individual images, called slices, across three planes. These images allow radiologists to see a snapshot of what is occurring in your lower spine as they move across each plane.

What a Lumbar Spine MRI Scan Can Diagnose

If you have lower back pain, a lumbar spine MRI may be recommended to discover the cause. If your back pain is in your upper back, your doctor may suggest an upper back, or cervical spine MRI and if it’s more concentrated in the middle of your back, they may recommend a thoracic spine MRI. 

An MRI scan of the lower spine is used to diagnose (and rule out) numerous conditions, including:

Degenerative Disc Disease

Between each vertebra of the spine sits a piece of cartilage called an intervertebral disc that cushions the bones of the spine. Over time, these discs can become worn, causing a painful condition called degenerative disc disease. A lumbar MRI can detect these degenerative changes and help doctors create a treatment plan. 

Herniated Disc

The intervertebral discs can also become torn through trauma, injury or overuse, leading to pain, stiffness and mobility problems. 

Spinal Stenosis

The spinal canal houses the spinal cord and the other nerves and nerve roots of the back. Stenosis causes a narrowing of the spinal canal, causing some of the nerves to become pinched or compressed, causing pain, stiffness, muscle weakness and immobility. 

Sciatica

If the sciatic nerve that runs down the spine into the buttock area becomes compressed or pinched, it causes pain in the back and buttocks. 

Spondylolisthesis

Spondylolisthesis causes one or more of the vertebrae to move forward, causing pain most commonly in the lower back. 

Spinal Tumours

An MRI scan will highlight tumours of the spine, that may be malignant (cancerous) or benign (non-cancerous). 

Spinal Infections

Infections in the bones and/or soft tissues of the lower spine can occur as a result of injury or previous surgery, or they can travel to the area via the bloodstream or from the surrounding soft tissue. 

Compression Fractures

If one or more of the vertebrae are under pressure, for example, from osteoporosis (also called lumbar spondylosis if it affects the lower back), injury or weakened bones, it can cause tiny fractures called compression fractures, that lead to pain, stiffness and mobility problems. 

Inflammatory Conditions

Inflammation caused by injury, trauma, infection, ligament sprains and muscle strains causes pain, swelling and heat in the spine, and can be detected on an MRI scan. 

Congenital Spine Abnormalities

A congenital spine abnormality is a condition that someone is born with, that causes abnormalities in the growth of the spine. 

Why Do I Need a Lumbar MRI Scan?

Several symptoms would cause your doctor to order a lumbar MRI scan. These include:

• Spinal defects at birth
• Chronic lower back pain
• Spinal injury
• Back pain accompanied by fever
• Weakness, numbness in your legs

These can all signify something occurring in your spine, or spinal column. For example, a herniated disc can apply pressure to your spinal cord, this pressure on the nerves can present itself in any area of your lower body. The only way to determine is through an MRI scan. The scan will show which nerves are being compressed and where the treatment needs to be focused.

Can a Lumbar MRI Detect Nerve Damage?

A lumbar MRI is a prognostic tool used to identify the anatomy of the lower spine. It can identify the bones, cartilage, spinal cord, and spaces the nerves travel through the spine. While the procedure can't identify damage to the nerve, the scan can identify compression. This compression could be caused by a herniated disc, or a tumour pressing against the nerve. When the results of the MRI are combined with the symptoms the patient is experiencing, a diagnosis can be made.

How an MRI Scan of the Lumbar Spine Works

Each tissue, from the dense bones to the soft tissues including the muscles, blood vessels and cartilage that cushions the bones, contain hydrogen atoms. An MRI machine uses radio waves and strong magnetic fields to temporarily disrupt these hydrogen atoms, and in doing so, creates energy. Each tissue creates a different level of energy, and is transformed into an image by MRI computer programming. A radiologist then reads these images in order to diagnose or rule out different conditions that can affect the lower back. 

Equipment Used

An MRI machine is a round, doughnut-shaped medical scanner that uses radio waves, strong magnets and computer programming to create detailed images of the inside of the body. Attached to the MRI machine is a medical table that slides in and out. Patients are required to lie still on the table as it moves into the machine to enable the highest quality images.

Benefits

An MRI scan is suitable for most patients, and is a quick, pain-free way of allowing doctors to view inside the body, without having to perform surgical or invasive procedures. Unlike x-rays and CT scans, an MRI scan doesn’t use ionising radiation and therefore doesn’t come with the risks of radiation exposure. 

Risks

Patients who have claustrophobia or who struggle to remain still may find an MRI scan daunting and overwhelming. If you think you may find it difficult to enter an MRI machine, speak to your medical team as they may be able to provide you with a mild sedative that will help. 

Sometimes, a contrast dye is administered via an intravenous drip, to better highlight the blood vessels, ligaments and internal structures on the resulting images. Some patients develop a reaction to these dyes - patients with kidney problems appear to be more at risk of such allergic reactions. Symptoms include breathlessness, excessive sweating and muscle weakness. If you begin to experience these symptoms or you feel unwell, let your radiographer know straight away, 

How to Prepare for a Lumbar Spine MRI Scan

Most MRI scans don’t require any special preparation and you can eat, drink and take any medication as normal beforehand. However, all removable metallic objects such as hearing aids, jewelry and watches must be removed before entering the scan room, due to the strong magnets used. If you have any metallic implants, stents, valves, screws or plates, let your radiographer know beforehand. 

How Long Does a Lumbar MRI Take?

A typical lumbar MRI scan takes approximately 10–30 minutes to complete. In some instances, a contrast material is needed to highlight specific structures in the spine. If this is the case, the procedure will take longer.

How is a Lumbar MRI Performed?

A lumbar MRI scan is a non-invasive diagnostic procedure. It is pain-free and does not require any recovery time.

Similar to other MRI scans, you will be asked to change into a hospital gown. Some centres will allow you to wear loose-fitting clothing if it's more comfortable for you, but each centre will have its policies.

You will be instructed to lay down on the MRI table, the technician may use straps, foam blocks, or other devices to ensure your spine is in the correct alignment. If you experience any discomfort, inform the technician and they will do their best to make you comfortable.

The table will slide into a doughnut-shaped machine. There are two common types:

1. Standard MRI - this will look like a long cylindrical tube.
2. Short-bore MRI - the tube of this MRI is about half the size of a standard MRI.

A short-bore MRI performs the same function, however is more favourable for those suffering from claustrophobia.

The machine will make loud humming and banging noises throughout the scan. This is to be expected and should cause no alarm. The loud noises can be startling, making it difficult to stay still during the procedure. Therefore most clinics offer earplugs to make you more comfortable.

Once the scan is complete the technician will go over the images, during this time you may have to wait a few minutes. Once the technician approves the images you are free to return to your daily activities.

A radiologist will review your scan and send the results to your doctor. You will be contacted by your doctor’s office to schedule an appointment to discuss the results of your MRI lumbar scan.

How Do You Read an MRI Lumbar Scan?

Once you understand how an MRI is taken, you will be able to better understand what you are looking at in the results.

An MRI scan takes images over three planes:

• Axial - from top to bottom
• Sagittal - from one side to the other
• Coronal - from front to back

As if you were slicing an apple from one side to the other, each apple slice represents an MRI image as it moves across the spine, along a single plane. The images produced show varying colours that represent the structures in the lumbar spine.

It takes a trained radiologist to find the nuances in colour changes to identify inflammation, tumours, fractures, and obstructions. The results of your scan can be used to correlate your symptoms and find the root cause of your discomfort.

What Happens After a Lumbar Spine MRI?

Once your radiologist is happy they have the right detailed images, you can get up from the MRI machine and get dressed. If you’ve had a contrast dye MRI scan, you’ll be required to remain in the clinic for half an hour to monitor you for an allergic reaction. 

Getting the Results

Your radiologist and referring doctor will review and discuss your results, along with your symptoms and medical history,  before discussing them with you. This may take a few days to a week. 

What Does a Lumbar Spine MRI Cost?

In the UK, a private lumbar MRI scan starts at around £250. 

Get a Lumbar Spine MRI Scan

Having lower back pain can significantly impact your quality of life, freedom to move around without pain and your ability to work, exercise and play sports. Book a private lumbar spine MRI scan with us today, and discover the cause of your pain and discomfort. 

In Conclusion

Almost 4 out of 5 people in the UK will suffer from back pain in their lifetime. It’s currently the leading cause of disability. It can be a hassle to deal with and it can be challenging to admit you need to see your doctor. But diagnosis is the first step in your recovery journey.

At Scan.com we offer appointments up to six times faster than the NHS.

If you are tired of experiencing lower back pain, make an appointment at one of our MRI centres and let us help get you back to living pain-free.

References

1. https://medlineplus.gov/ency/article/007352.htm
2. https://aica.com/will-nerve-damage-show-up-on-an-mri/
3. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq5157
4. https://www.radiologyinfo.org/en/info.cfm?pg=spinemr
5. https://rockymountainbrainandspineinstitute.com/understanding-mri-lumbar-spine/
6. https://www.healthline.com/health/back-pain/lower-back-spasms
7. https://mayfieldclinic.com/pe-mri.htm
8. https://hpi.georgetown.edu/backpain/
9. https://www.theregenerativeclinic.co.uk/news/80-uk-adults-experience-back-pain/
10. https://www.healthline.com/health/lumbar-mri-scan#procedure
11. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Lumbar-Spinal-Stenosis
12. https://emedicine.medscape.com/article/1148690-overview
13. https://healthcareextreme.com/how-to-read-mri-lumbar-spine-in-8-easy-steps/