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Low Back Pain: Unmasking the Hidden Causes (And How MRI Solves the Mystery)

By Brian Tsui, MD
June 2, 2025

Let’s face it: Most adults will battle low back pain at some point. But what’s actually causing that nagging ache or sharp twinge? While most cases stem from everyday wear-and-tear, other culprits—like infections, cancer, or even hidden organ issues—can lurk undetected. Let’s break down the suspects and how whole-body MRI cracks the case.

The Usual Suspects: Mechanical Pain & Osteoarthritis

Disc Degeneration

Your spinal discs (think: jelly-filled shock absorbers) can wear down due to age, injury, or genetics. This creates inflammation that irritates nearby bones and nerves—often leading to:

  • Shooting pains in arms or legs
  • Pain that worsens with movement
  • Weakness or stiffness

Facet Joint Arthritis

These small joints at the back of your spine can grind when cartilage wears thin. The result?

  • Bone spurs (osteophytes) that pinch nerves, causing shooting pains
  • Pain when bending backwards
  • Tenderness to pressure

MRI Insight: A detailed scan reveals disc bulges, joint erosion, and inflammation hotspots—key clues for targeted treatment.

Fractures

Since your spine is a bone, it can also break and cause pain! There are a few ways this can happen:

  • Stress fracture: repetitive stress on the spine such as from weightlifting can cause a fracture in the area called the pars, a narrow part of the bone in your spine, which can then cause the bone to slip backwards or forwards.
  • Trauma: injury can cause a fracture
  • Osteoporosis: decreased bone mineral density can cause bone to fracture even from everyday actions such as coughing or sneezing
  • Cancer: cancer cells invade the bone, weakening it (see more below)

Silent Threats: When Back Pain Isn’t Just a Strain

Cancer

Certain cancers such as breast or prostate cancers can spread to the spine. When the cancer deposit gets big enough, it can cause fractures or even compress nerves, causing pain. CoreViva MRI is able to detect small cancer deposits, which can then be controlled before they get bigger and cause issues.

Infection

Infections from different parts of the body can spread to the spine. Bacterial infection can lead to destruction of the disc and adjacent bone, which can lead to pain. A CoreViva MRI is able to evaluate if there is an infection that could be causing your symptoms.

Autoimmune arthritis

Many different forms of autoimmune diseases such as rheumatoid arthritis or ankylosing spondylitis can affect the spine. Rheumatoid arthritis typically affects the neck portion of the spine known as cervical spine, leading to destruction of the joints and the bone, causing pain and neurologic symptoms. In contrast, ankylosing spondylitis usually affects the sacroiliac joints in the pelvis first, then the low back, and eventually the neck if not controlled. Because many rheumatological diseases have different patterns of involvement in the spine, a CoreViva MRI can pinpoint which disease is most likely occurring, giving you and your treating doctor the pathway to treatment and recovery.

The Plot Twist: When Your Back Isn’t the Problem

Ever heard of referred pain? Your kidneys, pancreas, or other abdominal organs can send “decoy” pain signals to your back. Sometimes, you might feel the pain in the back, but it’s actually from your abdomen. For example, kidney cancers can cause back pain. These diseases in the abdomen can be missed on a dedicated spine MRI because the images are focused on the spine only. In contrast, CoreViva’s MRI is comprehensive, evaluating the whole body, so we are able to detect any abnormalities in the abdomen or pelvis that could be causing your back pain.

Key Takeaways:

  • Most back pain is mechanical but there can be serious causes that are best detected with MRI
  • Whole body MRI evaluates all possible conditions causing your back pain

At CoreViva, our radiation-free MRI scans can uncover fractures, tumors, and map severity of your arthritis.

Stop wondering, start healing. Book your scan today and let our radiologists hand you the answers—not just images. Know Your Body.


About CoreViva

CoreViva is a physician-led health technology company redefining preventive care with advanced whole-body MRI. Our mission is to improve early detection and treatment through the nation’s most advanced whole-body MRI, wellness education, and a world-class patient experience. By combining state-of-the-art imaging, AI-enhanced diagnostics, and compassionate care, CoreViva empowers individuals with deeper insights into their health—before symptoms arise. Learn more at www.coreviva.com and Know Your Body.

Brian Tsui, MD, Chief Medical Officer

Dr. Brian Tsui is the Chief Medical Officer at CoreViva and a former attending radiologist at UCSF with a clinical focus in neuroradiology and research in artificial intelligence and MRI protocol optimization. He has authored nearly 40 presentations, publications, and book chapters with topics including brain vessel imaging, women’s imaging, and musculoskeletal tumors.