Lumbar Spine MRI: Info and Get a Scan
A lumbar spine MRI is a detailed, radiation-free scan of your lower back. It shows the vertebrae, discs, nerves and surrounding soft tissue, which helps find, or rule out, the cause of persistent lower back pain, sciatica and related symptoms. This page explains what the scan shows, when it is worth having, what to expect and what it costs.
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 is the lower section of your back: the five vertebrae between your ribs and your pelvis, labelled L1 to L5.
• L1
• L2
• L3
• L4
• L5
These vertebrae are larger than those higher up the spine because they carry more load and absorb more shock. They also protect the spinal cord and nerves. In most adults the spinal cord itself ends at around the L1 to L2 level, tapering into a cone-shaped structure called the conus medullaris. Below that point, a bundle of nerve roots known as the cauda equina (Latin for "horse’s tail") continues down through the spinal canal and supplies the legs, bladder and bowel. Between each pair of vertebrae sits a ring of cartilage called an intervertebral disc, usually just called a disc, which cushions the bones.
If any of these structures is damaged or abnormal, it 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, which causes abnormalities in the growth of the spine.
Why Do I Need a Lumbar MRI Scan?
A doctor might order a lumbar MRI if you have symptoms such as:
• Chronic lower back pain
• A spinal injury
• Back pain alongside a fever
• Weakness or numbness in your legs
• A spinal problem present from birth
Any of these can point to something happening in the spine or spinal canal. A herniated disc, for example, can press on the spinal cord or nerves, and that pressure can show up as symptoms elsewhere in the lower body. An MRI shows which nerves are affected and where, so treatment can be aimed at the right place.
Can a Lumbar MRI Detect Nerve Damage?
A lumbar MRI is a diagnostic tool that maps the anatomy of the lower spine: the bones, cartilage, spinal cord and the spaces the nerves pass through. It does not show nerve damage directly, but it does show nerve compression, for example where a herniated disc or a tumour is pressing on a nerve. When those images are read alongside your symptoms, a clinician can work out whether that compression is likely to be causing your pain, and a diagnosis can be made.
How an MRI Scan of the Lumbar Spine Works
Every tissue in the body, from dense bone to soft muscle, blood vessels and the cartilage that cushions the bones, contains hydrogen atoms. An MRI machine uses strong magnetic fields and radio waves to briefly disturb these atoms. As they settle back, each tissue gives off a slightly different signal, and the scanner’s software turns those signals into images. A radiologist then reads the images to diagnose or rule out the conditions that can affect the lower back.
Equipment Used
An MRI scanner is a large, doughnut-shaped machine that uses radio waves, strong magnets and computer software to create detailed images of the inside of the body. A padded table slides you in and out of the scanner, and you need to lie still while the images are taken so they come out clear. Many centres use high-field 3 Tesla (3T) scanners, which produce higher-resolution images, though a good-quality 1.5 Tesla (1.5T) scan is often more than enough for the lower back.
Benefits
An MRI suits most people and is a quick, pain-free way for doctors to see inside the body without surgery or other invasive procedures. Unlike X-rays and CT scans, it does not use ionising radiation, so it does not carry the risks that come with radiation exposure.
Risks
If you have claustrophobia or find it hard to stay still, an MRI can feel overwhelming. Mention it to your medical team beforehand: they may offer a mild sedative, or you might prefer an open or upright MRI.
Sometimes a gadolinium-based contrast dye is given through a drip to highlight blood vessels, ligaments and other structures. A small number of people react to the dye, and those with kidney problems appear to be more at risk. Symptoms can include breathlessness, excessive sweating and muscle weakness, so tell your radiographer straight away if you feel unwell during or after the scan.
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, jewellery, 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:
- Standard MRI - this will look like a long cylindrical tube.
- 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.
Treatment and Next Steps
An MRI is a diagnostic step rather than a treatment, but it usually points clearly to what should happen next. What that looks like depends on the finding:
• Muscular pain and mild disc wear are often managed with physiotherapy, staying active and time.
• A herniated disc pressing on a nerve may settle with physiotherapy, or be treated with a steroid injection or, less often, surgery.
• Spinal stenosis may be managed with physiotherapy and injections, and surgery is considered if symptoms are severe.
• A compression fracture linked to osteoporosis usually means treating the underlying bone density as well as the pain.
It is worth remembering that scans commonly show some wear and tear that is not actually causing your symptoms, which is why the images are always read alongside your history and examination rather than on their own.
Your report and images can be shared with your GP, a physiotherapist or a specialist, and a post-scan consultation is available if you want to talk the results through.
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.
FAQs
Does all back pain need an MRI?
No. Most back pain is short-lived and settles without a scan. An MRI is most useful for pain that persists, follows an injury, or comes with warning signs such as leg weakness, fever or unexplained weight loss.
Do I need a GP referral for a private lumbar MRI?
No. With Scan.com you do not need a GP referral. A pre-scan consultation with a clinician is included, and they arrange the referral for you if a scan is appropriate.
Can I drive home after a lumbar MRI?
Yes. A standard lumbar MRI does not affect your ability to drive, so you can drive yourself home and return to normal activities straight away. The exception is if you are given a sedative to help with claustrophobia, in which case you should arrange for someone else to drive.
Will the scan definitely show what is causing my pain?
Not always directly. A lumbar MRI shows the structures of the lower back and any nerve compression, but scans often reveal normal wear and tear that is not the source of symptoms. That is why the images are read alongside your history and examination.
What's the difference between a lumbar, thoracic and cervical spine MRI?
They scan different parts of the spine. A lumbar MRI covers the lower back, a thoracic spine MRI covers the mid-back, and a cervical spine MRI covers the neck. Your doctor will recommend the one that matches where your symptoms are.
Is a lumbar MRI safe if I am pregnant?
MRI does not use radiation and no harmful effects on pregnancy have been documented, but contrast dye is usually avoided. Always tell the team if you are, or might be, pregnant so they can plan the scan accordingly.
References
- https://medlineplus.gov/ency/article/007352.htm
- https://aica.com/will-nerve-damage-show-up-on-an-mri/
- https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq5157
- https://www.radiologyinfo.org/en/info.cfm?pg=spinemr
- https://rockymountainbrainandspineinstitute.com/understanding-mri-lumbar-spine/
- https://www.healthline.com/health/back-pain/lower-back-spasms
- https://mayfieldclinic.com/pe-mri.htm
- https://hpi.georgetown.edu/backpain/
- https://www.theregenerativeclinic.co.uk/news/80-uk-adults-experience-back-pain/
- https://www.healthline.com/health/lumbar-mri-scan#procedure
- https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Lumbar-Spinal-Stenosis
- https://emedicine.medscape.com/article/1148690-overview
- https://healthcareextreme.com/how-to-read-mri-lumbar-spine-in-8-easy-steps/
