When to order MRI for low back pain

Published on 01 Oct 2020
Last Updated on 01 Oct 2020

This ACE Clinical Guidance (ACG) covers the use of magnetic resonance imaging (MRI) of the lumbar spine for diagnostic investigation of low back pain, providing evidence-based recommendations on the role of MRI for low back pain that is non-specific or linked to a specific spinal pathology.

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When to order MRI for low back pain (Oct 2020) [PDF, 988 KB]

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ACG recommendations

1. Patients with non-specific low back pain, with or without radicular symptoms: MRI is not indicated.

2. Patients with non-specific low back pain despite 4 to 6 weeks of conservative management: MRI may be indicated.

3. Patients with low back pain and progressive neurological symptoms or signs: MRI is indicated.

4. Patients with low back pain and suspected cauda equina syndrome: MRI is indicated.

5. Patients with low back pain and cancer or infection (suspected or known): MRI is indicated.

6. Patients with new or progressive low back pain following an invasive procedure on the lumbar spine: MRI is indicated.