Lumbar degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain.
Have you been told that you have a disc bulge at L4-L5? Are you scared that you may need surgery after reviewing your imaging results? Have you been told that you have to stop a particular activity for good?
Patients often come to physical therapy with their MRI results and are worried about the results.
Do Spinal MRIs Matter?
MRIs are a useful tool for visualizing soft tissue structures and potential pathologies. However, a 2015 Systematic Literature Review found that MRI imaging will show disc bulges and herniations in the lumbar spine in ASYMPTOMATIC individuals without any low back pain.
The study found that in asymptomatic individuals, disc bulge prevalence was 30% in people 20 years of age and increased to 84% in people 80 years of age (W. Brinjikji, 2015).
The authors of the study concluded that: “Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient’s clinical condition” (W. Brinjikji, 2015).
Takeaway?
The results of the study mean that patients should have clinical signs and symptoms that are consistent with MRI findings before an imaging result can be considered meaningful.
Furthermore, disc pathology observed on an MRI can be a natural part of aging and does not necessarily conclude that it is the root cause of pain.
How Do You Find Out if Your Symptoms are Consistent With MRI Results?
A physical therapist can go through a lumbar evaluation screen using clinical tests, measurements, and symptom review to determine if the MRI results are consistent with the root cause of injury. Based on the clinical presentation, disc pathology is treatable and surgery can be avoided.
Do You Always Need an MRI if You Have Low Back Pain?
Although MRIs are useful tools, you do NOT always need an MRI if you have low back pain.
If you are experiencing low back pain and believe it may be coming from a disc issue, physical therapy can help! Call Respire Physical Therapy today at 703-671-1871 or click here to schedule an evaluation with a Physical Therapist today. Get back to the activities you love without worrying about low back pain.
References
- Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations
- W. Brinjikji, P.H. Luetmer, B. Comstock, B.W. Bresnahan, L.E. Chen, R.A. Deyo, S. Halabi, J.A. Turner, A.L.Avins, K. James, J.T. Wald, D.F. Kallmes, J.G. Jarvik
- American Journal of Neuroradiology Apr 2015, 36 (4) 811-816; DOI: 10.3174/ajnr.A4173
Tags: movementismedicine, low back mri, Low Back Pain, Natural Pain Relief, choosept, arlingtonva, alexandriava, fallschurchva, ptworks, Physical Therapy, Respire Physical Therapy, painfreeliving, physical therapist
