Article by PTOSI Therapist, Scott Darling, DPT
Chances are, you or someone you know has experienced low back pain at some point in your life. Usually the first step people think of is to go to the doctor and get an MRI. Yet, contrary to popular belief, results on an MRI are frequently not associated with the cause for their low back pain! One of the goals during my first visit with the patient is to explain to them that their MRI findings are a small piece of the puzzle within their chronic low back pain. While it’s important to note their disc degeneration and herniations revealed on the MRI, it is not helpful to only focus on these findings, because for the most part, they are NORMAL. Yes, disc degeneration and herniations are normal, and people without back pain can have worse looking MRI results than those with low back pain.
A recent study published in 2015 gives credibility to my position on this. In the article, Brinjikji et al. compiled 33 studies that looked into MRI findings in patients without low back pain and what types of abnormalities were noted. As you can see in the figure provided, disc issues in the low back are very prominent in people without any low back pain to speak of. The highlighted portion shows that by the age of 40, 68 percent of people without low back pain have disc degeneration. Therefore, if you are 40 and your MRI reveals this finding, it most likely has nothing to do with the reason you have low back pain. All of these findings show that issues in the low back are very common to see even if you do not have any low back pain. If the only avenue to explaining your pain is within an MRI, normal findings could be and commonly have been mistaken as the reason you are in pain.
This is precisely why it’s important to look at the whole picture of why you’re experiencing low back pain, and get a comprehensive evaluation to get to the root cause of your pain. At PTOSI, our comprehensive evaluation includes determining the cause of pain which could be from weakness, joint restrictions, range of motion or soft tissue integrity that can’t be assessed from an MRI. We will strive to figure out the reason for your pain and get you back to the life you lived prior to the pain you’re experiencing. If you’re experiencing pain and have tried everything, give PTOSI an opportunity to decrease or eliminate your pain; we have 32 years of experience doing so!
|Image Finding/years of age||20||30||40||50||60||70||80|
|Disc signal loss||17%||33%||54%||73%||86%||94%||97%|
|Disc height loss||24%||34%||45%||56%||67%||76%||84%|
Click here to read more about MRI findings not associated with pain.