X-ray and MRI findings for your pain?

It is very common in our profession that someone goes to their Doctor with low back pain.  They are often then prescribed medication for their symptoms and an advanced imaging such as an X-ray or MRI in an attempt to get further information about why they are in pain.  

The results come back and they found out they have bulging discs, degenerative disc disease, spinal stenosis and a host of other problems.  But are those things they find on imaging actually related to why they are in pain?

  The answer is, sometimes but not often. 

 If we took imaging of a group of people who have no pain, in a portion of them you would find many of the same problems:

 In one study, lumbar disc degeneration is found in more than 40% of people under the age of 30 and 90% of people between 50-55.  Many of these people not having any symptoms and being completely functional.  This is why we do not often use imaging in physiotherapy in an attempt to explain why someone is in pain.  We use clinical tests which give us a complete picture and not just a snapshot in time of normal degeneration.  

Since seeing degeneration on an image is commonplace, we view it more as similar to wrinkled skin which is a normal change with age.  If you want more information on why you may have back, shoulder or hip pain see a qualified health professional and don't just rely on imaging!

 Physio Summum Brossard

*This type of imaging is more relevant for serious conditions which present with red flags such as fractures, suspected cauda equina, tumor, etc.

See the graphic below to see how imaging results across the body don't give us the full picture of why someone has pain. (available in french)