Fighting MRI Fatigue

By Stephanie Buxhoeveden, RN, MSCN

3 min read

Throughout my life, I have always been affectionately labeled as "accident-prone." Maybe it was because of the time I broke my leg skiing and needed a couple of surgeries to put it back together. Or from the time I crashed a moped in Bermuda with my best friend on the back, landed us both in the ER, and left with a plaster souvenir on my arm. Who knows?! But thanks to my many colorful adventures, I had already had several MRIs of various different body parts when I was diagnosed with MS.

The discomfort of a brain and spine MRI

I used to not care about MRIs at all. Heck, sometimes I even fell asleep! Now, I know the glory of the brain/triple spine MRI with and without contrast, and along the way, I have stopped appreciating being shoved into a tube. My legs now insist on spasming, my bladder refuses to give it a rest for a couple of hours, and the pressure points on my back and head get so painful that I have actually cried. A couple of years ago, the accident-prone, no-pain-no-gain version of myself may have rolled her eyes at someone insisting an MRI could be that awful. Now I know better!

Did you know that MS actually stands for "multiple scans?" I'm totally kidding, but it sure does feel that way at times. As clinicians, we live and breathe MRI results. They are the best tool that we have for measuring how our patients are doing, if the medications are working, and monitoring for serious conditions like PML.

Silent damages

Silent damage is when an MRI shows some new lesions but the patient has no new symptoms. In response, a doctor may hold off on changing medicines since it seems like a fairly benign change and because the patient outwardly is no different then they were at the last visit.

But I've heard some doctors suggest that the goal of therapy should be to aggressively try to stop this silent damage from occurring in the first place. Because once the patient develops a big enough lesion that does cause symptoms, then you have let the proverbial horse out of the barn. That, of course, is only one view of how to manage this. But the point I'm trying to make is that MRIs are extremely important when it comes to tracking our patients' progress.

MRIs feel like a necessary evil

So I, as a patient, have concluded that MRIs are a necessary evil. Important, but not fun. However, I have come up with a few strategies that have actually really helped me fight the dread and fatigue that can come with MRIs:

1. Music

I found out that my radiology location can plug in my iPod and play a custom playlist. I now have a great MRI playlist that both distracts and calms me.

2. Find my "zen"

I've never been very good at meditation or yoga or any other relaxing activity really (I need to work on that), but I do love a good massage. When I can, I get one the day before my MRI. Then when it's time for my scan, my muscles are a little bit more relaxed and less inclined to jump around. Also, when I'm in the MRI machine, I try to relive the massage head to toe and try to relax each muscle as I go...much like you do in meditation.

3. Speak up!

Now that I know I get those painful pressure points on my back and on the back of my head, I let the radiologist know and they have been able to pad those areas a little better. Tell them if there is anything they can do to position you more comfortably, and push that button if you get too hot or too cold.

So in summary, being a musical, zen, loudmouth has helped me fight my MRI fatigue and anxiety. I haven't tried taking sedating medicine because I usually drive myself to and from my appointments, but many of my patients have. It's important to communicate with your doctor if you do experience anxiety during MRIs.

Work with your doctor or nurse to make it more comfortable

Most importantly, if you ever do experience MRI fatigue or anxiety, try talking to your doctor or your nurse. Some people choose to refuse MRIs altogether. That is a personal decision, but maybe we can help you find something that makes it better. Or maybe you and your doctor could come to a compromise before you get to that point.

Best of luck!

Follow along on Jennifer’s MS journey

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balooga Member
Just a comment about having sedation with MRIs -- it's the only way to go for me. Prior to MRIs I never knew that I was claustrophobic, but when I got into that coffin-like tube with my head surrounded by what seemed like a bird-cage type of object to prevent me from moving, that did it, my claustrophobia quickly emerged! Now conscious sedation is a requirement for me, it's painless and zones me out so that I have no sense of time or even any recall of what it was like while in the tube. And headphones with music completes the experience, just close your eyes and drift away for a while . . . . something to consider doing for yourself.
1. deborahgostin Member
 I've heard this from folks, and what I've been able to do for myself (because I've always had to drive myself to and from) is to focus on the fact that I am really just inside this thing for a little while to be helped, not hurt, and I am not really stuck anywhere, and that I can get out anytime if I really need to… This has helped me, but if you're happy all drugged up to avoid all the unpleasantries then, hey, go for it! 😉
2. maschabrautigam Member
 Mmmm i take valium but not enough to make me drift <a href='http://off.so' target='_blank' rel='noopener noreferrer ugc'>off.so</a> claustrophobic that even 1/2 vallium does not <a href='http://help.What' target='_blank' rel='noopener noreferrer ugc'>help.What</a> does help is putting me in 10 mins and then out,but they can not always do <a href='http://this.Helps' target='_blank' rel='noopener noreferrer ugc'>this.Helps</a> too is the little mirror on my head so i can see them controlling the machine etc and the press button for sure!!!
msmarple Member
I find MRIs nearly intolerable, even with music, until I discovered two things that make it all (sort of) bearable: Valium first, then I ask the technician to mark the time for me, so I know what's coming. She tells me at the beginning of each scan, "This will last minutes. It makes all the difference. I know I can tolerate three minutes or even ten minutes of something intolerable as long as I know it will end. As for the music, though, be careful what you ask for. Once a tech. asked me what music I like. Classical, I said. How about Mozart? Fine. It was the Requiem!! That's funeral music, I screeched. So I went with the crashes and thumps, and the next MRI, I said that I adore Broadway songs 😀
1. Stephanie Buxhoeveden, RN, MSCN Member
 I do like when they count down too, it definitely helps. I always bring my own iPod fully loaded with music...no chance of any funeral music while I'm in a giant coffin sized magnet!! 😀
gbear Member
I enjoyed the blog on MRI fatigue. My last MRI was a little under a year ago with another coming up soon. I never had a problem with MRI's until my last one when an anxiety attack crept up on me during the scan. I didn't say anything to anyone, just dealt with it. After the test, the tech offered me a tissue because she though my nose was running because of how cold it was in there. Mabe she didn't notice the sweat on my brow, or my soaked gown. None the less, I think I might ask my Doc for something to help me relax, just in case.
Laura Kolaczkowski Moderator & Contributor
I clearly remember my first MRI in 1992 - it was for a back injury and not MS. The tech asked if I would like music and I said yes, anything would be fine. They rolled me in and the music started and it only took me about 30 seconds of the most twangy '70s style country music to have me pushing the emergency button. I survived the scan, but only after they stopped the Porter Wagoner. Thanks for these very useful tips.
1. Stephanie Buxhoeveden, RN, MSCN Member
 For me it's "Somewhere Over the Rainbow". I've heard that song so many times in an MRI machine that it now makes me shiver when I hear it out in the real world too! My radiologist and I have gotten to know each other and he knows that if I hear that song I will crawl out of the machine just to bonk him on the head! 😀
2. becky57 Member
 It's good to hear of someone having such a great relationship with their radiologist! Lol
teresal Member
I wish I had read this blog before my recent MRI - I have had 2 in the past and they were no problem, but this time, 3 and 1/2 years since the last, the joint discomfort and pain on the back of my head was excruciating. It is good to know that it was not just my imagination, but that others have had similar experiences. Thanks for the suggestions and for encouraging us to speak up and let our doctors and caregivers know if we are in discomfort - we tend to just deal because that is our nature often.
deborahgostin Member
When I first started getting MRIs (very early 90s) I was okay with everything, though I didn't like them much. A few years ago I was having two-three areas of my back looked at because I didn't want to have to return for each area. Mistake! The MRI was taking way too long, and I think the techs were doing something wrong that prolonged it. But I was spastic and in pain and it was miserable. I used to always have the option of a headset w/music and a pair of earplugs. The techs would always call out the times before each scan began. I find that to be one of the most important things to help ease the anxiety of the wait….. all techs should always do this!! My last MRI, I had to push that button to ask them to please do it - and it wasn't all that easy to get them to provide me with music AND earplugs either! These are procedures I thought were standard, but I am finding this not to be so true after having had multiple MRIs over many years.
hendlern1 Member
I've learned over the years to close my eyes before I enter the tunnel so I don't know how tight it really is in there. I find my happy place to concentrate on which is riding a horse out in an open field or through the woods jumping fallen trees as we go. Next thing I know the MRI is over and I've slept for an hour. Who needs drugs?
1. jmeyer Member
 Sorry Sara, but while your scenario sounds beautiful I can't focus like that. I need sedation
2. usafrnped Member
 Hi Sara, I have found doing the exact same thing helps going in the tube. Plus like you, concentrating on some other thought process than being in a confined space!!!
maschabrautigam Member
My problemen is clostrophobia!!Lots of anxiety and panic even with <a href='http://valium.my' target='_blank' rel='noopener noreferrer ugc'>valium.my</a> question is how often do we need one done?I had mine 6 months ago and they seem to be eager to do many in France....i thought once a year is enough?I am to the point of refusing but then they say'oh madam we cannot help you <a href='http://then.Very' target='_blank' rel='noopener noreferrer ugc'>then.Very</a> French...,
dianeg Member
I had my first MRI in <a href='http://Feb.1991' target='_blank' rel='noopener noreferrer ugc'>Feb.1991</a>. I hadn’t yet been diagnosed & I was a little anxious about the MRI. When I walked into the room where it was, I realized that it was a large room with just a large white tube at the far end of the room. When they put me in it, I closed my eyes and kept the picture of that big empty room in my mind. I still do that. At that time, they didn’t provide earplugs. In fact, all through the ‘90’s, ear protection didn’t seem to be high on the priority list. The noise it makes now is so much quieter. It used to sound like someone was using a jack hammer on my head! Thankfully, it’s not nearly as loud and now we get earplugs!
jmeyer Member
The only way I've ever been able to get through them is with sedation. I'm not claustrophobic but the noise combined with being restrained with my head in a cage freaks me out - BIG time!
nobu Member
I am still in the "I sleep in the MRI" stage of MS going on 18 years. But my last one was almost the best yet. The technician was originally from Brazil, and when I ask if he had jazz music, well, I got bossa nova. I was in music heaven. And we talked bosa and Brazil afterward. And now instead of a washcloth over my eyes, they have a nice little eye mask. The only somewhat goofy MS session I had was a 3 hour full head, back and spine - I must have lost 2 lbs in sweat from the heat. Other than that, I can still fall asleep or practice counting in a foreign language, and then backwards if I am brave enough.
nobu Member
MRI session, not MS session.
usafrnped Member
I enjoyed your short note on MRI fatigue. As a pro in the tube (we all are if we've had the exams multiple times over the years), I have learned, as you suggested, to speak up for comfort etc. I now make sure I'm padded as well as we can accommodate to alleviate some of the pressure point and pain. Does it work, I have to say yes, if you have a cooperative MRI tech to help. To help with the time in the tube listening to the clangs and bangs, I've also learned that pre-medicating for pain and relaxation helps. I may be sleepy after, but it sure makes the exam easier on my spastic muscles and the restless limbs that always seem to know when it is time to start their dance. Thank you for sharing your tips to help us get through the experiences... have to add, my hospital also has music, but the MRI noise is so loud that you can't hear it.
jmeyer Member
There's nothing I can do about the fatigue as I have to be sedated Not sure why - I'm not claustrophobic but the noise combined with being restrained with my head in a cage freaks me out big time
sealy Member
I am so happy to read this article because when I mentioned this was starting to happen to me with each new MRI my neurologist looked at me as if I had suddenly grown another head and said he had never heard of anyone saying that before. I assumed I was just being a wimp, the last one was the worst because my legs starting doing their dance, I wanted to scream and jump out but eventually got through it. I am concerned I am going to have to try to find someone to go with me so I can take a Valium. so strangely enough I am glad to find that it is not all in my mind. Thank you for all you suggestions.
august16 Member
Thank you for this article - and the range of additional tips in the comments. I don't need the extra padding yet but will remember to ask for it when I do. (Mental note...on second thought, I'd better make a real note!) I haven't needed medication but find an eye mask, or washcloth over my eyes, to be very helpful. My local places allow me to go into the tube in my own clothes, so I have a special MRI "non-metallic" outfit: sweats (no grommets), T-shirt, light long-sleeved cardigan (no buttons & sleeves loose enough for the contrast IV) & fun socks. It makes the whole thing more comfortable. I just slip off my shoes, toss my jewelry in my purse & throw it all into the locker. I have to change into a gown for MRI's at Mayo - but it's a substantial gown, and I still get to wear my fun socks. I like the warm blankets & ask for two if I'm especially chilly. At first, I didn't want the techs to think of me as demanding. However, they've since told me that it's easier to provide a patient with what they want/need than have to guess what they want/need. If a patient is polite & fairly cheerful, they're happy to accommodate any reasonable requests. I also like them to give me time indicators. "This set will take 3 minutes," etc. Like others have said, it breaks it up into manageable increments. When I was first getting MRI's, I'd be nervous about the results & I'd be 'hoping hard' that I was ok. At some point, though, I realized that I had whatever I was going to have. There was no need for me to hope so hard for an outcome. The outcome was decided. I could just relax. I had done my part for the time being. That was surprisingly liberating. I try to maintain that state of mind, in general, when it comes to dealing with MS. It's a lot less stressful. Of course, I don't always manage this. Believe me, I can pitch a fit now & then! Pity Party, table for 1... I try to leave that party early, though. Good luck, everybody. Thanks for the camaraderie & sharing your tips!
1. bstraiton Member
 MRIs at Mayo? As in Mayo clinic in Rochester, MN?
venus Member
My Dr. gives me a valium to take about 1 hr. prior to MRI. That has made remarkable change for me. I've had many MRI's being DX with MS since 1999, and I hated them! But now that I use the relaxer there not as bad.
1. Shelby Comito Community Admin
 Thank you for your comment <inline-mention user-id="4104269" username="venus"/> ! I'm so glad to hear you've found something that works for you. We appreciate you sharing your experience with the community and hope you will continue to do so! Warmest wishes, Shelby (MultipleSclerosis.net Team Member)
bstraiton Member
My first year or 2 of MRIs I did just fine with just having music. Then we started having major delays due to spasms in my legs and arms and neck. After a 45 min scan took almost 2 hrs my Neuro gave me clonopin to partially sedate me and stop the spasms. Now I have a great routine that starts the night before and I also have an MRI outfit that's metal free and very cozy. I'm now just over 5yrs since diagnosis and my Neuro team and I have a great system for making MRIs as painless as possible. But yes you MUST speak up and advocate for yourself. There's nothing worse than wasting a ton of energy being uncomfortable or panicked in a tube and then having to go on with your day.
tammon71 Member
I'm not claustrophobic but I have a swallowing issue called nut cracker esophagus where fluid collects in my air way and I feel like in choking. They try to lift/tilt my head but they also need it flat and straight. So with the cage I and laying flat I start to feel like I'm drowning. Not to mention the spasticity is getting bad. This last 2 MRI's I felt I was still but they kept saying I needed to be still. One of my newer symptoms this last year has been facial twitching I'm wondering if it's not my whole body after that experience.
carolynwilhite Member
My husband can’t breathe lying flat, so he had to get his done at Upright Open MRI. He sat down with an open area during the imaging. It is the only place in our state that has one.
ggpcjt Member
Dye can be an issue. I have heard that it doesn't flush out. And drink a lot of water after mri. Do check out my source to validate.
1. itasara Member
 I read about the dye and so for the past two scans I have not had any dye. Lesions can still be seen without dye, but not as clearly and in my case not as necessary. If a new lesion was seen I would most likely have to repeat the test using dye.
georgi54 Member
I had MRI’s today that totaled 2 hours and so I feel your pain, literally. My head hurt and lower back was on fire...I was so stiff when I was done that the Tech had to practically scoop me off the table. It’s embarrassing when a young man the age of my son has to help me so much, but her I am, an older woman who has MS and can’t do it all anymore. I am just thankful I can do what I can now...I also have a wonderful husband who helps me.
1. itasara Member
 My last MRI have brain w/o die probably took about 40 minutes. Maybe less. Spinals take a lot longer if that is what you had that added up to two hours.
2. becky57 Member
 Did you get a support under your knees to keep your back from screaming at you?
20qv8sx Member
I have grown to hate MRIs. I get worse & worse & tge radiologist says @no change”. Ha! Not wasting any more insurance money on that crap!
georgi54 Member
My last MRSs took over 2 hours even though I got to “move” inbetween. I was so sore and stiff I nearly cried and had to have the much younger tech help me off the table when it was done. I simply could not move at all.
colette4 Member
Stephanie, I never could stand those MRIs every six months to check our lesions. I never felt comfortable in them, the music didn't help because I couldn't hear it well enough, I was in pain and all that noise gave me a headache. I can't believe that you were so relaxed that you even fell asleep! Recently I had a 3T MRI which is supposed to be very intense - I had to breathe slow and steady and was scolded several times about my breathing! That MRI seemed the worse I have ever had and do not want that kind again. I'll just stick to the old trusty MRIs that we are used to enduring.
1. Janus Galante Moderator
 What an awful thing to have experienced vvxjr9! Besides the pain and noise, then to be scolded because you weren't breathing "right!" That's difficult enough to do when you're in pain! I'm so sorry you had that experience! Thank you for sharing it...Janus
2. becky57 Member
 What a terrible experience! At the very least, I would not want to have that tech again! If you need another MRI, and there's no other tech, I would mention it to your doctor, and request a different place.
itasara Member
My first MRI was in 2005. Following year I had another one. Then I was on medication for about 12 years and my doctor at the time felt I was doing so well with no major relapses at all and he felt I did not need any MRI's. Then he decided to have one done at about 12 years of medication. There was essentially no change, no active lesions but a couple spots he was unsure of so he sent me to an MS specialist. I had no previous MRI's except the first ones to show any kind of history, which really should have been done and made my first visit a little difficult. So I switched to this MS specialist and am glad I did. I never minded the MRI's that much. I had one spinal in-the beginning and that one does take a lot of time. Then a spinal last year-nothing new except for the usual signs of spinal aging. My new neurologist agreed with me that since I have never shown any progression,I could come off MS medication. I wanted an MRI every 6 months so I wouldn't worry. So far I have had two and now she wants to make that yearly. I looked forward to the MRI just to be sure that I was not showing any more lesions, because even with an active lesion, there may not be any obvious symptoms. But I said ok and will have another one a year from now. This last time I had music played which helps mitigate the banging noise. Otherwise I play games.. The technician announces how many minutes the next scan will be and I start counting to myself in my head to see if I can match the time it takes to complete the scan. Keeps me busy!! I have been of MS meds now for one year.
1. becky57 Member
 I have no changes in my MRIs in several years, but my symptoms have gotten worse. I do need back surgery, which could be part of my problem, but I could also be entering SPMS. I don't think we'll know until after my surgery and rehab. The virus is making it very difficult to get the surgery done. Anyway, we have internet based medical access to our records, which has the radiologist reports of the MRIs. I suggest that if you have access to this type of program to use it. I can also email my different providers with questions, concerns, get med refills, etc.
itasara Member
PS just want to add that I always get a copy of the MRI on <a href='http://disc.after' target='_blank' rel='noopener noreferrer ugc'>disc.after</a> each MRI scan. After a number of years, medical records may lose track of MRI reports and older discs. I recommend anyone to keep an MRI copy. If you ever move or change doctors, it is good to have them, but don't let anyone borrow them. I did that and although I was promised to get them back, I did not. Finally after much complaining I got new copies made of the old discs. I hope they are the same.
1. Janus Galante Moderator
 This is a great tip to remember itasara. Thanks for sharing it! Janus
becky57 Member
Up until several months ago, the longest I had to go through an MRI, was about an hour and a half. At my first one they did the brain and neck. Because of my chlostraphobia, I was given a Valium to take 1/2 an hour prior to the scan. It didn't do anything for me. However, that's when I found out that they had headphones and I could pick a music channel. I was good from then on. My last MRIs were for brain and all three sections of my back. The music quit working 1/2 way through this 3 - 3 1/2 hour session. Fortunately, I had enough tunes in my head to recycle them. The last couple of times i've had a problem with my left shoulder, and she's been great about padding it so I don't end up in tears. Makes me wonder how guys manage the space, or lack thereof. I get dry mouth from some medications, and learned not to mention that I have 1/3 of a piece of chewing gum in my mouth to keep it from drying out. I don't "chew" it, but in between series, I roll it around ro remoisten my mouth. I was glad to have my whole back done, as we found out that my last fall caused a compression fracture where the lumbar meets the thoracic, and that I have a congenital stenosis in the cervical. Up until a few months ago I only had to deal with MRIs once a year, or every two years. In the last nine months, I can't count how many I've had.
brainspots Member
Today is 10-1-2020 I had my second closed brain M.R.I. today since I was diagnosed in 2018 with Relapse Remitting M.S....my symptoms are going downhill fast so your not alone...this time even 5 hours later i still feel warm and fatigued it's hard to stand and do dishes over the warm water and I was diagnosed at age 34 🙁 I'm 37 now and I cry sometimes knowing I can't do what a man my age can do
1. Erin Rush Community Admin
 Your comment really touched me, <inline-mention user-id="4038481" username="brainspots"/> ! I am sorry your disease progression has been so aggressive. Please know you are not alone and we have a number of men in this community that can understand what you are feeling. Thank you for taking the time to join this conversation! Best, Erin, <a href='http://MultipleSclerosis.net' target='_blank'>MultipleSclerosis.net</a> Team Member.
renee52 Member
I have primary progressive MS anybody else that has it and best ways to handle it

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