Don’t perform magnetic resonance imaging (MRI) of the spine within the first six weeks in patients with low back pain in the absence of warning signs or symptoms (red flags).

Type of practice


Topic Area

Medical Radiology

Usually MRI is prescribed at the first complaint of back pain and sciatica, without performing a first-line conservative treatment with both pharmacologic and nonpharmacological (e.g., exercises, remaining active) therapy. In the absence of serious neurological or systemic symptoms, lumbosacral MRI for both acute and chronic lower back pain and sciatica is not routinely recommended, but should be considered only if there are persistent or progressive symptoms during or following 6 weeks of conservative treatment.
If MRI shows no pathological findings it should not be repeated within 24months.In the absence of red flags (such as cord compression or spinal cord injury) in patient history or physical examination, an MRI or other imaging techniques in the first six weeks, usually don’t modify the therapeutic approach but could lead to incidental findings, to perform other unnecessary examinations or surgery, or to ionizing radiation exposition; all representing a high cost for society.


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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.