January 2

Why Your MRI Doesn’t Tell the Whole Story

Here’s a story we hear all too often...

You get back pain and you’re worried so you go to the doctor.

Your doctor orders an xray.

It's normal.

You go back to the doctor because the pain is still there.

You’re prescribed some medication and sent for an MRI.

Your MRI shows you have a disc bulge. 

You panic because a bulging disc doesn’t sound good.

You get a cortisone shot/take pain killers for weeks or have surgery.

Maybe it works, maybe it doesn’t.

Not exactly a fairytale ending....

What is often overlooked is that the imaging does not correlate with your pain or your symptoms.

How do we know this?!

Science. Studies have taken people who are NOT in pain and this is what they have found:

30% of 20 year olds have disc bulges without any symptoms and 84% of 80 year olds have disc bulges with no symptoms. 

What’s more, this situation is true for many conditions; such as neck pain, rotator cuff pathology, hip labral injuries, degenerative disc disease, and arthritis.

So what do I do?!

Chances are, even if you get imaging for one of the above conditions or suspected injury in one of those areas, you’re likely going to be referred to PT, and we’re going to treat your pain and function based off a functional exam and detailed subjective history – which often gives us much more detailed information regarding your symptoms than an image does (as it only shows us a single snap shot in time). 

This does not mean that imaging is useless – however, it is often a poor story teller of what is really driving your symptoms. The body is a highly adaptive system. You may have sustained a disc bulge unknowingly, or have tendinosis of your shoulder asymptomatically for months or years before an image is taken. So what has changed? The imaging or the ability of your body to adapt to SOMETHING (not always necessarily what is reflected in imaging)? In our experience it is usually the latter. Let us help you readapt to the demands of your life.

References:

  1. https://pubmed.ncbi.nlm.nih.gov/25430861/

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