Ah, the MRI, the Magic Radiology Instrument, known to diagnose and even cure all known diseases! The MRI is a modern-day snake oil, and helping patients change their thinking about the purpose or value of an MRI is hard to overcome. It seems that everyone's neighbour, friend, and relative has had an MRI!

When it comes to back pain, Choosing Wisely Canada has 5 recommendations. You can read them all yourself (check out the "Quick Links" section of this newsletter), or just keep reading here for our one-sentence summary:

Basically, for patients with complaints of low back pain, imaging (even plain x-rays) is not recommended, regardless of duration of symptoms, in the absence of red flags.

The Choosing Wisely recommendations also contain an extensive reference on the harms and benefits of low back imaging (also available in the "Quick Links" section of this newsletter).

You can overcome your patients' demands for MRIs by explaining this to the patient while taking note of his/her history and conducting a physical examination in the context of looking for and ruling out red flags. Choosing Wisely has a simple one-page handout which you can print/fax/email to patients to help them understand(again, located in the "Quick Links" section).

You can also get the conversation started with a poster in your exam room! Click the image below to download and print your own, or contact us using the button below and we'll print you a copy.