Should I get an MRI for back pain?

Usually no — at least not first. Current evidence-based guidelines (NICE, ACP, JAMA) recommend that uncomplicated low back pain be treated conservatively for 4–6 weeks before imaging, because most cases resolve in that window and MRI findings often don't change the treatment plan. Worse, incidental findings (disc bulges, mild degeneration) common in pain-free adults often get blamed for symptoms they didn't cause, leading to unnecessary interventions.

MRI is indicated immediately if there are red flags: progressive neurological deficit, bowel/bladder changes, unexplained weight loss, history of cancer, recent significant trauma, or persistent symptoms after 6 weeks of conservative care. A good clinician screens for these on visit one.