Don't Let Your MRI Fool You

Many individuals who have back pain, knee pain or any other joint pain expect that they should have an MRI pretty early on in their care. However, this may come with some unnecessary risks. The research on this is eye opening, so stick with me as I shed light on a few realities that you should be aware of.

Reality #1: “Abnormal” findings on your MRI are not necessarily the source of your symptoms. 

You read that right! Here are some pieces of evidence that might give you some perspective: 

·      A large systematic review in the American Journal of Neuroradiology reported that 20% of 20-year-olds, 80% of 50-year-olds and 96% of 80-year-olds had disc degeneration (osteoarthritis) on MRI but absolutely no pain.

·      The same systematic review found that 29% of 20-year-olds and 43% of 80-year-olds had disc bulges but no symptoms. 

·      In a BMJ study, 86-88% of asymptomatic individuals had at least one knee pathology or abnormal finding on MRI.

Considering that this is only a small sampling of the evidence on this, the implications are compelling. If that many individuals with absolutely no pain have these MRI findings, how can we honestly pin point these things as the source of pain for those that do? If these findings are this common, are they really “abnormal?” In the same way that our skin wrinkles as we age, our internal structures have wear and tear. Yet, this does not necessarily equate to pain. 

Reality #2: “Abnormal” MRI findings greatly increase the likelihood of risky medical interventions.

Opioid use, injections, and surgery occur at a much greater rate when an MRI is obtained, regardless of the severity of findings or patient presentation. The time, money, and risk associated with these solutions hardly outweigh the benefits when you consider the fact that what they are attempting to fix may not be the actual problem.

Reality #3: “Abnormal” MRI findings sound scary and create fear.

Heightened anxiety surrounding a diagnosis or symptom is strongly associated with that condition becoming chronic. If the findings themselves are irrelevant to the solution, then the fear is unnecessarily created and only serves to make the situation worse. 

So what should you do first when you get knee pain, back pain, neck pain, etc? Research shows that you should go to physical therapy as stop number one. The sooner you get seen, the more likely it is that you recover conservatively. If you are worried about missing a condition that may be more serious, you can rest assured that doctorate level physical therapists are trained extensively on screening for red flags and determining when imaging would be necessary. 

Unless your bone is sticking out of your leg or your arm is twisted the wrong way, get into physical therapy right away. Seeing a physical therapist first, you’ll be increasing your chances of a successful recovery that is less time consuming, less risk and less costly.