Before you book an MRI

MRI, consultant or 4D scan? Which should come first.

An MRI looks at one spot while you lie still. Our 4D scan looks at how your whole body moves, standing and walking. Here is how to decide, honestly.

Clinically reviewed by Nadine Hemming (MSK Podiatrist, HCPC-registered) and Andy Hemming (MSK Specialist) · Last reviewed October 2026

The laser beam

MRI, X-ray and specialist appointments

A precise look at one spot. Excellent when the problem really is in that spot, and essential when something serious needs ruling out.

But you are lying still, one area is examined, and scans often find wear and tear that is normal for your age and not the cause of your pain.

The beam of light

Our DIERS 4D assessment

A measured picture of your whole body while you stand and walk: feet, knees, hips, pelvis and spine, all at the same moment.

It shows how the parts affect each other, so a back that keeps flaring up can be linked to the way one foot loads.

Already had a scan?

Had an MRI that didn't explain your pain? You're not alone.

Many people come to us after a scan or a specialist appointment that ended without a clear answer. There is a good reason for that.

  • Scans find things that are not causing pain. In people with no back pain at all, disc degeneration shows up in about 37% of 20-year-olds and 96% of 80-year-olds (Brinjikji et al., 2015). A finding only matters if it explains your symptoms.
  • NICE does not recommend routine imaging for most low back pain outside specialist settings, because it rarely changes what should happen next (NICE guideline NG59).
  • Pain often comes from how you move, not just what is there. A knee that keeps flaring up can trace back to a pelvis that rotates more to one side, or a foot that loads unevenly. A scan of the knee alone will not show that.

Bring your MRI or X-ray report

If you have already had imaging, bring the report. We go through it alongside your 4D results, so you get the structural picture and the movement picture together, explained in plain words.

Side by side

How the options compare.

ComparedMRIX-rayConsultant appointmentDIERS 4D assessment
Looks atOne area: discs, nerves, soft tissueOne area: boneYour problem area, and may order scansYour whole body, feet to spine, and how the parts connect
You areLying stillStill, standing or lyingExamined in the roomStanding and walking
Shows movementNoNoPartly, by examinationYes, measured
RadiationNoneYes, a low doseNone (scans extra)None
You leave withA report for your referrerA report for your referrerA diagnosis and medical optionsA report of findings and a rehab plan you can start straight away
Typical self-pay cost£360–£490 for one area£99–£149 per area£150–£350, plus any scans£99–£350, depending on package
Referral neededYes, a clinician must justify itYes, a clinician must justify itOften, or pay an extra feeNo, book directly

Costs are typical published self-pay prices from Cheltenham and national imaging providers in October 2026 and will vary. Some national providers include the referral step through an online questionnaire. MRI and X-ray show things our scan cannot, such as discs, nerves and bone. If you need one, we will tell you, and as HCPC-registered clinicians we can refer you.

So which should come first?

Start with us if…

  • Your pain has built up gradually or keeps coming back
  • You have had scans or treatment and still have no clear answer
  • Pain moves around, or affects more than one area
  • You want to understand why, and leave with a plan

See a doctor first if…

  • You have any of the warning signs below
  • You have had a significant injury and may have broken something
  • Your symptoms are getting rapidly worse
  • We assess you and think imaging is needed: we will tell you, and can refer you
Your safety comes first

When you do need an MRI, a doctor or A&E.

Go to A&E or call 999 now

If back or neck pain comes with any of these, you need emergency care, not a scan:

  • Numbness or tingling in the groin, buttocks, inner thighs or genital area
  • New bladder or bowel problems: you cannot pass urine, or you lose control
  • Weakness in the legs or feet that is getting worse, such as foot drop, or numbness that is spreading
  • Severe spinal pain at night that wakes you and does not ease when you lie down or change position
  • Fever, chills or night sweats with spinal pain

See a doctor first

We will not scan until a doctor or HCPC-registered clinician has ruled out a structural or medical cause if you have:

  • A recent significant injury, such as a hard fall, sports collision or car accident, with a possible fracture
  • A history of cancer and new or unexplained spinal pain
  • Unexplained weight loss alongside the pain
  • Severe osteoporosis or long-term steroid use
  • Difficulty standing still or walking unaided, because of pain, spasm, dizziness or balance problems

Our scan measures the surface of your body and how it moves. It cannot see discs, nerves or fractures, which is why these checks come first. For urgent advice that is not an emergency, call NHS 111.

Where most people start

Unresolved pain? Start with the full picture.

Most complete

Unresolved Pain Assessment

For pain that has not settled, even after scans, specialists or months of treatment.

£3502-hour deep dive

The full DIERS 4D motion lab: formetric 4D spine (static & motion), Leg Axis (posterior & lateral) and pedogait. Your whole musculoskeletal system measured together, standing still and moving.

  • Medical history and in-person clinical evaluation
  • Full synchronised scan, feet to spine
  • Report of findings, gone through with you on screen
  • Rehabilitation plan: exercises, manual therapy, posture, movement and gait cues, footwear suggestions, orthotic options
  • Some hands-on initial treatment where possible
Book this scan →Free 10-min chat

Something more specific?

We also offer focused packages from £99:

Not sure? Try our two-minute self-check.

Common questions

Does a 4D scan replace an MRI?

No. An MRI shows discs, nerves and soft tissue in one area. A DIERS 4D scan measures your posture and how your whole body moves. They answer different questions. If you need an MRI, we will tell you, and we can refer you.

Can you refer me for an MRI or X-ray?

Yes. Any scan has to be clinically justified by a healthcare professional. As HCPC-registered clinicians we can refer you on when a scan is needed.

My MRI showed disc bulges or wear and tear. Is that why I hurt?

Not necessarily. Disc changes are very common in people with no pain at all, and become more common with age. A finding only matters if it explains your symptoms.

Is a DIERS scan as accurate as an X-ray?

For measuring posture and spinal shape, studies show strong agreement with X-ray for key measurements and very high repeatability. It does not show bone directly, so it is not a substitute where an X-ray is clinically needed. See the research.

Let's find out what is actually going on.

Book online, or start with a free 10-minute chat if you are not sure what you need.

Book Now → or call 01242 650810