After weeks of neck pain, I finally had an MRI. There was a tumor the size of a golf ball pressing on my neck nerves causing the problem. Why don't they make MRIs mandatory for everyone with neck pain? It could certainly save a lot of time and money spent on treatment that doesn't help.

Your situation is the exception rather than the rule. Of the 28 million people who reported neck pain last year, 10 million saw their doctors. Eight per cent (80%) of those individuals got better with treatment to treat the symptoms. Most often this included antiinflammatories, muscle relaxants, and physical therapy.

This is a fairly typical big picture view of neck pain. Doctors know that further testing is really only needed in a small number of cases. Patients who don't get better on their own or who don't get better with conservative care are the best candidates for advanced imaging studies.

X-rays are usually ordered first. If further tests are needed, MRI or CT scans are done. The physician makes the decision as to when additional testing is needed and what to do based on patient history and the results of the examination. Failure to improve after three months of conservative care is also an indicator that more testing is needed.

The high cost of MRIs keep this from being a standard test given to anyone and everyone with neck or back pain. This is especially true given how many people with neck pain have normal MRIs and the number of abnormalities seen on imaging studies in people with no symptoms at all.