OBJECTIVE:

To examine early magnetic resonance imaging (MRI) utilization for workers compensation cases with acute, disabling low back pain and further, to examine low or high propensity to undergo early MRI with disability duration, medical costs, and surgery.

METHODS:

Two-year follow-up of 3264 cases. Cox regression and generalized linear models were used to examine the association between both early MRI (first 30 days postonset) and propensity of belonging to the early MRI group (estimated by demographic and severity indicators) with outcomes.

RESULTS:

A total of 21.7% cases had early MRI. After controlling for covariates, cases that had early MRI and simultaneously had a low propensity to undergo early MRI were more likely to have worse outcomes.

CONCLUSIONS:

The majority of cases had no early MRI indications. Results suggest that iatrogenic effects of early MRI are worse disability and increased medical costs and surgery, unrelated to severity.