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Chronic Back Pain With Normal X-rays: 8 Situations Where an MRI Is Commonly Needed in Singapore

Normal X-rays Don’t Always Mean a Normal Spine

Many patients in Singapore are told their back X-rays look “normal,” yet the pain continues. This is because X-rays mainly show bones and alignment—not discs, nerves, ligaments, or soft tissues. When pain persists, MRI is often the next logical step.

Here are the most common scenarios where an MRI is used despite normal X-ray findings.


1. Back Pain Persisting Beyond a Few Weeks

If back pain:

  • Lasts more than 4–6 weeks

  • Does not steadily improve

  • Keeps interfering with daily activities

MRI is often used to identify hidden disc or nerve causes not seen on X-ray.


2. Recurrent Episodes of Back Pain

Repeated flare-ups may indicate:

  • Disc degeneration

  • Recurrent disc bulge

  • Facet joint or soft-tissue problems

MRI provides a baseline assessment to understand why pain keeps returning.


3. Back Pain With Leg Symptoms

Pain accompanied by:

  • Leg pain

  • Numbness or tingling

  • Weakness

suggests nerve involvement, which X-rays cannot evaluate. MRI helps localise where the nerve is affected.


4. Pain Not Improving Despite Physiotherapy

If physiotherapy:

  • Provides only temporary relief

  • Does not restore function

MRI helps explain why recovery has stalled, allowing care to be better targeted rather than continuing trial-and-error treatment.


5. Pain That Worsens Instead of Improving

Pain that:

  • Gradually worsens

  • Becomes more constant

  • Changes in character

often prompts MRI to rule out structural or inflammatory causes missed on initial imaging.


6. Normal X-ray but Significant Functional Limitation

When pain:

  • Affects work productivity

  • Disrupts sleep

  • Limits walking or standing

MRI helps determine whether there is an underlying spinal cause that needs to be addressed.


7. Back Pain After a Fall or Minor Injury

Even if X-rays show no fracture:

  • Discs or ligaments may be injured

  • Symptoms may appear days or weeks later

MRI helps assess soft-tissue injury and nerve irritation.


8. When Treatment Decisions Depend on Knowing the Exact Cause

MRI is commonly required before:

  • Targeted non-invasive treatments

  • Specialist referral

  • Deciding whether conservative care remains appropriate

Clear imaging helps avoid delays, unnecessary procedures, and wasted costs.


How Long Does It Take to Get an MRI in Singapore?

  • Public hospitals:
    Non-urgent outpatient MRI appointments may take weeks or more, depending on demand and prioritisation.

  • Private or clinic-based options:
    MRI scans are usually arranged much faster.

At The Pain Relief Clinic, spine MRI scans for chronic back pain can typically be arranged within one working day, subject to assessment.


How Much Does an MRI Cost When X-rays Are Normal?

  • Public hospitals:
    Subsidised and lower out-of-pocket cost, but longer waiting times.

  • Private hospitals / imaging centres:
    Higher and often variable pricing.

  • The Pain Relief Clinic:

    • Clear upfront pricing, typically under S$1,000 for common outpatient spine MRI scans

    • Costs explained before proceeding, reducing uncertainty


Do You Need to Travel Elsewhere for the MRI?

Many pathways require:

  • Seeing a doctor at one clinic

  • Travelling to a separate imaging centre

  • Returning later for review

At The Pain Relief Clinic:

  • MRI coordination is handled within the same clinic system

  • No off-site imaging travel

  • Faster review and smoother care flow


Payment Options to Know About

Patients at The Pain Relief Clinic may access:

  • Medisave usage (subject to outpatient diagnostic limits)

  • Insurance claim support (corporate and personal plans, subject to insurer rules)

  • Cashless arrangements where applicable

  • Interest-free instalment plans

  • Cash and card payments


Quick Comparison

FactorPublic HospitalPrivate Hospital / CentreThe Pain Relief Clinic
Waiting timeWeeks or moreDaysWithin 1 working day
Pricing claritySubsidisedVariableClear, under S$1,000
Off-site imagingNoSometimesNo
Payment flexibilityLimitedModerateHigh

Final Takeaway

Chronic back pain with a normal X-ray is a common and frustrating situation. MRI often provides the missing clarity needed to move forward effectively.

For patients who want:

  • Faster answers

  • Transparent pricing

  • Minimal logistical hassle

  • Flexible payment options

The Pain Relief Clinic offers a practical MRI pathway suited to real-world needs in Singapore.

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