When back pain lingers, the natural next thought is often “I need a scan” or “maybe I need surgery.” Both can play an important role in the right situation. But for the majority of chronic low back pain, they are not the answer — and reaching for them too early can send you down a long and disappointing road.
What an MRI does and does not show
An MRI is excellent at showing structures: discs, joints, nerves. What it cannot show is pain. Researchers have repeatedly scanned people with no back pain at all and found bulging discs, degeneration and other “abnormalities” in large numbers of them. In other words, a finding on a scan is common — and does not automatically explain your symptoms. Treating an image rather than the actual cause of your pain is one of the most common detours in back care.
When medical investigation really matters
There are clear situations where prompt medical assessment is essential — for example progressive weakness, numbness, loss of bladder or bowel control, unexplained weight loss or fever alongside back pain. These red flags should always be checked by a physician. The point of the McGill approach is not to avoid medical care, but to make sure that surgery and scans are used when they are genuinely needed, rather than as a default for ordinary mechanical pain.
The McGill perspective
For most people, the key to chronic low back pain is not changing the structure of the spine, but understanding and removing the loads and movements that keep irritating it. When we identify your specific pain mechanism, recovery is often possible without surgery — by learning what loads your back, how to avoid those triggers, and how to build resilience over time.
Before you decide
If a scan or an operation is on the table, it is worth first understanding what is actually driving your pain. For many people that understanding changes the decision entirely.
Unsure whether you really need a scan or surgery? Apply for an assessment with Dr. Mark Bevers first, and find out what is genuinely causing your back pain.
