- Mechanical “damage” of the spine is correlated with spinal pain for people under the age of 50.
- But mechanical “damage” is also present in people who do not complain of lower back or neck pain
- Your MRI results may not actually show the root cause of the issue. Clinical assessment has to match MRI findings.
Spinal “damage” and pain
Lower back and neck pain are extremely common conditions, in-fact lower back pain is the number one reason for time off work due to sickness and has been shown to be 84% prevalent in some countries. Commonly, patients present at the physiotherapy clinic after being sent for an MRI by their doctor, the findings are commonly herniated (slipped) discs, degenerative discs, osteoarthritis and “trapped” nerves. The person is then convinced that their issue is due to the MRI findings and require surgery to treat the root cause of the problem. However, in reality the MRI findings could have absolutely nothing to do with the pain.
A study 2015 by Brinjikji and colleagues investigated the prevalence of spinal damage in people without spinal pain. The study correlated other studies who recruited people without lower back pain and used a CT or MRI scan to investigate the level of damage in their spines. Interestingly, the study found that spinal damage was extremely common in asymptomatic populations. . Although findings on MRI are common in patients without pain, they are MORE common in those with symptoms (Brinjikji and colleagues, 2015).
When is MRI appropriate?
MRI is always appropriate in people who suffer from symptoms that are called red flags. These are more worrisome symptoms which are not normal and should be reported to a professional if they arise. Presence of red flag symptoms generally results in an emergency MRI to investigate their cause. Some examples of these symptoms:
- Bladder retention (unable to pass urine)
- Loss of bladder control
- Sexual dysfunction
- Feelings of being unwell or generally under the weather
- Previous history of cancer
- Recent, rapid weight loss
MRI or CT imaging does not always discover the root cause of the pain. Clinical assessment from a skilled professional guided with imaging is more likely to find the root cause of the problem than imaging along. It is therefore important to get your condition assessed and treated by a skilled physiotherapist
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