When do I need an imaging test for my back pain?

On call

Q. I suddenly developed low back pain for the first time. My doctor said I did not need an x-ray or other imaging test. Is that normal and are there any situations when a test would be needed?

A. Yes, your doctor is following the current guidelines. Unless you have other symptoms in addition to low back pain, an x-ray, CT scan, or MRI is not likely to be helpful. But it could cause unnecessary worry while waiting for the results and cost you some money if it's not covered by your health insurance. In addition, many people have "false-positive" results in which an abnormality is detected but turns out to be harmless.