Ok, so you have pain and it didn’t get better with rest. What do you do next? Most people want to get an MRI to find out what’s going on. I mean, MRI’s are supposed to be super accurate, right?
Well, the answer may surprise you. What if I told you evidence shows that MRI findings and your diagnosis may have little in common?
I’ll provide you with some findings from 5 studies, but don’t think that it stops there. It would be exhausting to report on them all. These trends are evident in tons of studies. There are even studies looking at consistency between MRI reports from various providers/facilities on the same individuals. There was little to no consensus on MRI findings on the same person across multiple facilities...WHAT?! Why is there so much difference in the interpretation of an “accurate” picture?
A study was performed with 3110 people WITHOUT symptoms. This means they did not have pain. 80% of people at age 50 had findings of disc degeneration and 37% at age 50 had findings of disc protrusion. Scary right? Well these people didn’t even have pain.
This study had 1211 people also WITHOUT symptoms. 75% of people in their 20’s had cervical disc bulging. Actually, 87.6% of all participants had MRI reports of disc bulging.
72% of images of 53 people WITHOUT pain had “evidence” of a SLAP (superior labral anterior-to-posterior) injury. These participants were within the age range of 45-60.
45 people (ages 15-66) were examined. 69% of the people WITHOUT pain had MRI findings of hip labral tears.
If you’re still with me, this one is huge! 44 people (ages 20-68) WITHOUT symptoms had MRI imaging of their knees. 98% had MRI findings of meniscal injuries. Yes, that is 43 out of 44 people who were not complaining of knee pain.
Why is all of this important?
MRI’s are just one piece of the puzzle. It’s easy for a physician to jump to pills, injections, or surgery because the MRI shows damage. Even if you are in pain, and have these findings, I would challenge you to go through conservative treatment first. Yes, there are exceptions, but for the overwhelming majority surgery is not needed.
If the people in the above studies have signs of tearing, bulging, protruding, etc. without pain then that means YOU CAN ALSO BE PAIN-FREE with those findings.
Don’t get me wrong, there is a time and place for medical interventions. However, I want you to challenge the notion that just because your MRI shows something is off then you need surgery to “fix” it. I have heard way too many horror stories from surgeries, even the “simple” procedures.
What is more important to you: Being pain-free and doing the activities you love or Having a piece of paper say that your tear is “fixed”? Forget about what that stupid piece of paper says. Work towards reducing your pain naturally, improving your mechanics, and returning to the activities that you love to perform. Forget about those wrinkles in your body because that is exactly what they are, wrinkles (normal age-related changes).
Corey Hall, PT, DPT
Back: Brinjikji W et al. Am J Neuroradiol, 2014.
Neck: Nakashima H et al. Spine, 2015.
Shoulder: Schwartzberg R et al. Orthop J Sports Med, 2016.
Hip: Register B et al. Am J Sports Med, 2012.
Knee: Beattie KA et al. Osteoarthritis Cartilage, 2005.