Pain can, quite understandably, cause a lot of concern, worry, anxiety and distress. Particularly when it creeps into all aspects of our life and begins to limit our sleep, our social life, and the activities that bring us happiness. Oftentimes, that pain brings us to our health care provider and soon enough we’re having an X-ray or an MRI to see what is causing our pain. And that makes sense, right? We want to know what’s causing our pain because how can we “fix” it if we don’t know what’s broken?
Well, over the last ~20 years, we’ve learned that imaging doesn’t necessarily tell us what is causing our pain. As the great sports medicine surgeon, Dr. James Andrews stated: “If you want an excuse to operate…just get an M.R.I.” You see, as studies have recently begun to MRI people without pain, we’ve found these scans often show findings that we’ve previously associated with pain and disability such as rotator cuff tears, labral tears, disc degeneration, disc herniations….but these individuals have no pain.
To sum it up nicely, a 2014 review by Brinjiki et al stated that “signs of degeneration are present in very high percentages of healthy people with no problem at all. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain.”
Is it possible that it could be related to your symptoms? Of course it is. It’s also quite possible that it’s entirely a coincidental finding that could lead you down the road to unnecessary and prolonged treatment. Take these numbers into consideration from the study mentioned above, again, all from people who are pain-free:
- 20-29 year olds: 37% showed disc degeneration, 30% had disc bulging
- 50-59 year olds: 80% showed disc degeneration, 60% had disc bulging
- 80-89 year olds: 96% showed disc degeneration, 84% had disc bulging
So what does this mean for me?
It means that you are not your MRI results.
And it’s understandable that this may bring you frustration. Maybe you were told you had disc degeneration and then started to exercise less out of fear that you’d ‘do more damage.’ Maybe this lack of exercise has caused you additional issues such as worsening cardiovascular health, missing out on socializing with friends, as well as activities you enjoy. The truth is, however, that structured and progressive exercise is almost always the best option for improving pain and disability…not movement avoidance! This is great news for those suffering from pain. You are not a prisoner of your MRI and there is a way to get you back to being you.
Does this mean I should never get a MRI?
No! Imaging can be very useful for finding more sinister issues like tumors, trauma injuries, etc. However, most painful presentations can be diagnosed and treated through a thorough clinical examination.
So if I’m in pain, what should I do?
In Maryland you can see a physical therapist without needing a referral from another doctor. After a thorough examination, we can help you in your decision of whether or not further consultation or imaging may be helpful in your diagnosis and treatment. If you aren’t sure, ask your primary care provider if they think physical therapy may be an option for you!
Why physical therapy?
Often times, in the absence of severe trauma, physical therapy has comparable outcomes to surgery without the complications and potential risks that are inherent to any invasive treatment option. Furthermore, physical therapy is oriented towards empowering you to take control of your health and your body, teaching you to be independent in your own health. Lastly, your physical therapist will structure their treatment program to your individual goals.
You see, PTs don’t just try to identify and then treat a part of the body, we treat the person. You are not your imaging results. You are someone who wants to get back to work, someone who wants to get back to the playing field, someone who wants to get back to the garden – and that’s what we do, that’s what we treat: you.
Make an appointment and find out why FX Physical Therapy is built better, to make you better.
