Do I need a scan, X-ray or MRI for my pain?
When scans are and are not useful for back, shoulder and joint pain, why scan findings often do not explain pain, and who can arrange one.
It is natural to want a scan to find out what is wrong. In practice, for most ordinary back, neck, shoulder and joint pain, scans are not needed, and the results often do not explain the pain. They are most useful when your doctor suspects something specific that would change what is done.
What the guidance says
NICE guidance on low back pain and sciatica says imaging should not be routinely offered in non-specialist settings, that people referred to a specialist should be told they may not need imaging, and that in specialist settings imaging should be considered only if the result is likely to change management.
Why scans can mislead
Changes such as disc bulges, wear and tear, thickened tendons or a thickened bursa are common on scans, including in people with no pain, and become more common with age. An NHS trust leaflet on rotator cuff-related shoulder pain says that common shoulder scan findings are often present in people without pain and often do not explain it. A scan can also make people more worried or more cautious about moving than they need to be.
When a scan or other test is more likely to be useful
- After a significant injury, when a fracture or serious injury is suspected
- If there are warning signs, such as new weakness, numbness around the saddle area, bladder or bowel changes, fever, unexplained weight loss or a history of cancer
- When symptoms are not improving as expected, and the result would change the plan, for example before considering surgery or an injection
- When your doctor wants to check a specific cause, for example an MRI to look closely at soft tissues
Who arranges scans
Scans are arranged by your GP, a hospital doctor or an NHS musculoskeletal service, and in private care by a doctor or specialist. An osteopath can examine you and tell you whether they think a scan or a medical review would be sensible, and can ask your GP to consider one. The NHS describes an MRI as taking detailed pictures of the inside of the body to help find the cause of symptoms.
If you have a question that is not answered here, or you would like your symptoms assessed, you are welcome to get in touch or book an appointment.
Common questions
Should I get an MRI for back pain?
NICE says imaging should not routinely be offered for low back pain in non-specialist settings. A scan is more likely to be useful if there are warning signs or if the result would change the treatment plan.
My scan shows arthritis or disc degeneration. Is that the cause of my pain?
Not necessarily. These changes are common in people with no pain and become more common with age. A clinician will weigh the scan against your symptoms and examination.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
- NICE guideline NG59: Low back pain and sciatica in over 16s
- Leicestershire Partnership NHS Trust: Rotator cuff related shoulder pain
- NHS: MRI scan
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.