Magnetic Resonance Imaging, or MRI as we commonly know it, is an imaging tool that allows us to visualize tissues within our body. It can be a helpful resource and tool to assist with diagnoses and analyzing tissue damage when appropriate. For many people, getting a “positive” result on your MRI can be worrisome. Scary words are often thrown at you, such as “degenerative disc disease,” “bulging discs,” “arthritis,” and “tears.” It is understandable that there is a lot of fear that these changes are happening to your body and that those scary things must be the reason for your pain.
Research, however, has found that a positive finding on an MRI may not necessarily mean that is what’s causing your pain. People who do not have any back pain can still have “positive findings” on their MRI. Regarding the low back or lumbar spine, studies have shown that for people who were in their 20s, 37% had a degenerative disc and 30% had a bulging disc. For people in their 50s, 80% had a degenerative disc and 60% had a bulging disc. For people in their 80s, 96% had a degenerative disc and 84% had a bulging disc. Overall, about 40-50% of people will have something positive on their MRI, regardless of whether they have pain or not.
These studies show that sometimes tissue changes can be a normal part of the aging process, or as we like to say, “wrinkles on the inside.” There are even cases where you can have pain, but your MRI comes back completely negative. This provides us with some insight as to the relationship between your tissues and pain, and that sometimes, they may not be as closely related as we thought.
In summary, MRIs have their time and place to help with a diagnosis, however, it may not necessarily mean that what is found on your MRI is what is causing your pain. Work together with your doctor and physical therapist to determine whether there is indication to get imaging or if you can improve your symptoms and pain without it. A physical therapist can help you by taking you through a full examination, taking into account your history, checking your mobility, strength, and watching you move to help determine a treatment plan. Often, conservative treatment before getting an MRI is sufficient enough to improve pain and function, which in turn saves you money!
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