Should I Get an X Ray for Back Pain?

Should I Get an X-Ray for Back Pain? Key Considerations

Most people will experience back pain at some point in their life, but if you’re wondering, “Should I get an X-ray for back pain?”, the answer depends on your symptoms and their severity.

Here, we’ll look at when to consider an X-ray for back pain, what it involves, and the risks and benefits of X-rays. We’ll also look at other imaging tests that can be used to investigate back pain, as well as common causes of back pain.

Signs you need an X-ray for back pain

Back pain is a very common condition, and in most cases, you don’t need an X-ray. However, if you develop back pain after a recent injury or other trauma (eg a car accident), your doctor may recommend an X ray to check for broken bones (spine fractures).

Other red flags for back pain that suggest you may need a spinal X-ray are symptoms such as:

an inability to control your bowels or bladder
fever
muscle weakness and/or feeling unsteady when walking
severe back pain, back pain that lasts longer than 8 weeks, or back pain that radiates to other parts of your body
severe and/or worsening numbness or tingling
unexplained weight loss

Your doctor will also consider other factors that increase your chances of having a spinal fracture when deciding whether or not you need an X-ray. For example, long-term steroid use, osteoporosis or other age related changes in your body.

How does an X-ray work?

An X-ray is a type of diagnostic imaging that uses radiation to create 2D, grayscale images of the inside of your body. However, the radiation exposure is low and considered to be safe.

An X-ray generator will release a beam of X-rays that pass into your body. Your tissues will absorb different amounts of X-rays depending on how dense they are. Dense tissues like bone absorb the most X-rays, while areas filled with gas or air absorb very few X-rays.

Any X-rays that are not absorbed pass through your body and are picked up by an X-ray detector. These signals are converted into digital information and sent to a computer to create an X-ray image.

Dense tissues appear white, air and gas appear black, and all other tissues appear in varying shades of grey.

Risks of X-rays

As X-rays use radiation, they’re not recommended unless a doctor decides there’s a specific need for one. This is to avoid exposing you to unnecessary radiation.

For pregnant women, X-rays around the abdomen area are not recommended to avoid exposing the foetus to any radiation.

Benefits of X-rays

An X-ray is a very quick imaging test compared to MRI (magnetic resonance imaging) and CT (computed tomography), taking just a few minutes. X-rays are also painless, non-invasive and cost-effective.

For that reason, they’re often the first imaging test used in emergency situations when a bone fracture is suspected.

When X-rays are used to image bones, they don’t need a contrast agent – a small number of people develop an allergic reaction to certain contrast agents.

Understanding back pain causes

Back pain can be caused by any of the tissues in your back – your ligaments, tendons, muscles, nerves, cartilage and bones.

Damage, disease or injury to the bones in your back can happen anywhere along your spine. This includes your cervical spine (running from your skull through your neck), thoracic spine (in your chest area), lumbar spine (in your lower back), sacrum (in your pelvic area) and coccyx (at the top of your buttocks). It can also affect the spinal canal — the space that runs through the centre of your spine and protects your spinal cord and nerves.

The most common cause of back pain is a strained muscle or ligament. This can happen when lifting or moving something incorrectly, or repeatedly placing your back muscles and ligaments under strain. Poor posture can cause straining of the soft tissues in your back, leading to low back pain.

Other causes of back pain include:

a slipped disc – the cushion-like disc that sits between your spinal bones bulges out and can squash a nerve
ankylosing spondylitis – an autoimmune disease that causes inflammation of the spine
arthritis – this includes rheumatoid arthritis, which is an autoimmune disease, and osteoarthritis, which is caused by wear and tear over time
cauda equina syndrome – compression of the nerves at the bottom of the spinal cord
cancer – this includes cancer that starts in the spine or spreads there from elsewhere
sciatica – inflammation and/or compression of the sciatic nerve, which runs from the lower back, down the legs and into the feet

An X-ray, alongside further investigations, may be used to reach an accurate diagnosis of these conditions. Your doctor can then recommend a treatment plan for your back pain, such as physiotherapy treatment, changes to lifestyle factors, medication and/or surgery.

Alternatives to X-ray imaging

If your doctor doesn’t suspect that you have a spinal fracture, they may suggest other imaging tests that are better at creating images of soft tissues, such as muscles, tendons, ligaments and cartilage.

For example, MRI scans are often used to diagnose a slipped disc, while a CT scan is often used to help diagnose bone cancer.

Both CT and MRI create far more detailed images than X-rays, which are also 3D rather than 2D. This allows an area of the body to be investigated more easily from multiple angles. CT uses X-rays and computer technology, while MRI uses radio waves and powerful magnets.

Ultrasound is also used to image the back if, for example, you have an unexplained lump. This scan doesn’t use radiation or powerful magnets, but instead uses high-frequency sound waves. It takes less time than MRI and CT, and you don’t need to stay completely still as it creates live images of your body tissues.

Get to the bottom of your back pain

If you’re concerned about persistent or worsening back pain or are worried about the health of your back, get the clarity you need by booking a virtual GP consultation with one of our experienced Vista Heath GPs. They can then recommend the most suitable scan, such as a private X-ray at one of our nationwide clinics, or any further tests.