Questions About Imaging in Pain Care: Purpose, Results, and Next Steps

By the Pain Care Questions Team

Before agreeing to imaging for pain — an X-ray, CT scan, or MRI — ask what question it will answer, how results will be used, and what happens next. A short list of questions helps you and your clinician confirm the test is necessary before you have it done.

Why ask about imaging before agreeing to it?

Imaging is a tool to answer a specific medical question, not a routine step every pain visit requires. The U.S. Food and Drug Administration (FDA) explains that X-ray-based imaging — including radiography, fluoroscopy, and CT — should be performed only when a clinician judges it necessary to answer a clinical question, guide treatment, or monitor a condition. Asking what question the test is meant to answer helps confirm the test fits your situation.

Urgent symptoms come first

If you have sudden loss of bladder or bowel control, new leg weakness, numbness in the groin area, a high fever with severe back pain, or pain after a significant injury, treat this as urgent. Contact your clinician right away or go to an emergency department rather than waiting to schedule imaging on your own.

What can imaging for pain tell you — and what can’t it?

Understanding the basic tradeoffs behind imaging makes the conversation with your clinician more productive. Here is what the evidence shows, organized from most to least certain.

What is well established

• Imaging exams that use ionizing radiation — X-ray, fluoroscopy, and CT — work by passing radiation through the body to create images of internal structures, according to the FDA.
• These exams can help diagnose the cause of pain, support treatment planning, and guide certain procedures such as injections.
• Radiation exposure from imaging carries a small increase in lifetime cancer risk, and the FDA notes this risk depends on the radiation dose, the number of exams a person has had, their age, and the body part being imaged.
• CT scans generally involve a higher radiation dose than a standard X-ray, because a CT is built from many individual X-ray images.
• Options that do not use ionizing radiation, such as ultrasound or MRI, may be medically appropriate alternatives for some questions, and the FDA specifically recommends that referring clinicians consider them when appropriate.

What depends on your specific situation

• Whether the benefit of a particular scan outweighs the small radiation risk depends on your symptoms, history, and what the clinician is trying to rule in or out — this is not the same for everyone.
• Whether a non-radiation alternative would answer the same question depends on the body part and the suspected cause of pain.
• How quickly results are needed, and who explains them to you, can vary by facility and by the urgency of your symptoms.

What this article cannot tell you

This article cannot tell you whether a specific imaging test is right for your pain, what an image of your body shows, or what your results mean. Only a clinician who has examined you and reviewed your history can answer those questions.

What questions should I ask before an imaging test for pain?

The Agency for Healthcare Research and Quality (AHRQ) has long encouraged patients to ask direct questions during medical visits, noting that patients who ask questions and confirm they understand the answers tend to have more accurate diagnoses and better outcomes. Below are questions adapted from AHRQ’s patient guidance and applied to an imaging conversation.

About the purpose of the test

• What is this imaging test for, specifically?
• How will the results change what happens next in my care?
• Are there alternative exams that do not use radiation, such as ultrasound or MRI, that could answer the same question?

About preparation and the exam itself

• How is the test done, and how long will it take?
• Do I need to do anything to prepare — such as fasting, avoiding certain clothing or jewelry, or arranging a ride?
• Will contrast dye be used, and if so, what should I tell the team about allergies, kidney problems, or other health conditions beforehand?
• If I am or might be pregnant, have I told the imaging team? (The FDA specifically recommends this disclosure because of possible effects on a developing pregnancy.)

About results and follow-up

• When and how will I get my results?
• Who will explain what the results mean for my pain and my care plan?
• What are the next steps depending on what the imaging shows?
• Will this result be added to my medical record so future clinicians can see it and avoid repeating the same test unnecessarily?

What should I write down before I leave the appointment?

Consider writing down the answers to these three items before your appointment ends. This mirrors AHRQ’s advice to leave a visit with clear, written next steps rather than relying on memory.

1. The purpose: In one sentence, what question is this imaging test trying to answer?
2. The plan: What happens next once the results come back, and who will contact me?
3. The record: Where can I access a copy of this result later, so I don’t need to repeat the test if I see a different clinician?

Keeping a running list of the imaging tests you have already had — and when — is also worth doing. The FDA notes that reviewing a patient’s prior imaging history helps clinicians avoid ordering a duplicate exam that adds radiation exposure without adding new information.

Common questions about imaging for pain

Do I need imaging every time I have pain?

No. The FDA is explicit that X-ray-based imaging should only be performed when it is medically necessary to answer a specific question, guide treatment, or monitor a condition — not as a routine step for every episode of pain.

Can I decline an imaging test my clinician recommends?

You can always ask questions, request more information, or ask about alternatives before agreeing to any test. This article cannot tell you whether declining is appropriate in your situation — that decision depends on your specific symptoms and history, which only your clinician can assess with you.

Is a CT scan more risky than an X-ray?

According to the FDA, a CT scan generally involves a higher radiation dose than a standard X-ray, because a CT image is built from many individual X-ray exposures rather than one. This is one reason clinicians weigh whether a lower-dose option could answer the same question first.

Medical and educational disclaimer

This article is educational information only. It does not diagnose any condition, recommend for or against any specific imaging test, or replace a conversation with a qualified clinician who knows your medical history. Pain Care Questions is an independent educational publication at ThePainCenterUSA.com. It is not a pain clinic, treatment center, healthcare provider, referral service, or successor to any former business associated with this domain. Our sourcing and review approach is described in our Editorial Policy. If you are experiencing a medical emergency, contact local emergency services immediately.

Sources: U.S. Food and Drug Administration, Medical X-ray Imaging; Agency for Healthcare Research and Quality, Questions Are the Answer. Related reading: Start Here and How We Research and Use Sources.

Last reviewed: September 9, 2026.