MRIs can evaluate structures in further detail than x-rays, especially soft tissues.  When ordered for the neck or low back, it can assess if there is a herniated disc or other causes of a pinched nerve.  

One of the first questions that Dr. Garala is asked in the office by patients is if he can order a MRI to diagnosis the source of pain.  There is a misconception that MRIs can do this and are the SOLE determinant in providing a diagnosis (please read MRI Misconception under the Education Section).  MRIs are anatomical studies, which can provide SUPPORTING evidence of a clinical diagnosis.  

MRIs do not necessarily need to be ordered upon the first visit, especially if the pain just began, is not leading to any neurological deficits (i.e. muscle weakness or sensation changes) or won’t change the initial treatment.  Whether an MRI is ordered or not, the initial treatment plan will likely be the same, including medications and physical therapy.  If pain symptoms do not improve over time with these conservative treatments, an MRI may then be needed to then determine if the patient could benefit for a spinal injection, for which an MRI would be needed for planning purposes (to help establish the possible level of the pinched nerve and the safest route to the deliver the medication).

Please also keep in mind that since MRIs are considered advanced studies, they need prior insurance approval (they usually cannot be done immediately such as when x-rays are ordered).  Insurance companies usually have a list of guidelines that need to be met (medications, failed conservative physical therapy for six weeks) before they typically approve of getting an MRI.  

If you have any questions about getting an MRI, please let Dr. Garala’s team know. 

Click on the list of IBJI and outside MRI facilities for address locations and phone numbers.