Do I Need an MRI for My Back Pain?
Do I Need an MRI for My Back Pain?
Probably not yet — and that's good news. National guidelines are consistent: for most back pain, imaging in the first six weeks doesn't improve outcomes. It can make them worse.
What each one actually does
An epidural steroid injection doesn't fix the disc — it calms the inflamed nerve while the disc heals on its own. It's a bridge: pain control that lets you sleep, work, and do physical therapy during the natural recovery window.
Surgery (microdiscectomy) physically removes the disc fragment pressing the nerve. It relieves leg pain faster than conservative care — but studies consistently show that at 1–2 years, surgical and non-surgical patients end up with similar outcomes for most cases. Faster relief, same destination, plus operative risks.
When surgery is genuinely the right call
Progressive weakness (foot drop, a leg giving out) — this changes the calculus immediately.
Bowel or bladder changes with back pain — emergency, not a decision point. Go to the ER.
Severe, function-destroying leg pain that has failed 6–12 weeks of real conservative care, including injections.
If none of those apply, evidence supports starting conservative: therapy, time, and injections when pain blocks progress.
The decision framework we use
Rule out red flags (exam + imaging when indicated).
Start PT and activity modification — most patients improve within 6–12 weeks.
If nerve pain prevents participation in rehab, an epidural creates the window.
Reassess at each step. If you're the exception, we say so and refer you to a spine surgeon we trust — keeping a surgical candidate in injections is how you lose a patient's trust, and rightly so.
FAQs
Can a herniated disc heal on its own?
Yes — most do. The body resorbs disc material over weeks to months.
How many injections before considering surgery?
If 1–2 well-placed epidurals plus committed rehab haven't restored function, more injections rarely change the answer.
Will I be pushed toward injections here?
No. Our incentive structure is a plan that works; we refer surgical candidates out and tell you when conservative care isn't winning.
CTA: Call 720-749-5599 (CO) / 602-325-2024 (AZ).
