What does my MRI for low back pain mean?
Has a friend ever told you: “The MRI says that I have a herniated disc”?
You’ve probably heard that at least a dozen times.
As a physical therapist in Miami, I know I’ve heard it from nearly everyone I treat with low back pain and has had an MRI.
Athletes, non-athletes. Old. Young. Doesn’t matter.
And it does not mean much of anything. Well… doesn’t mean much when it comes to experiencing pain.
Do you know why?
Because there has been little to no evidence that those images can tell you how well you move or how much pain you have.
Take a look at these MRIs
This is what a normal lumbar spine (lower back) MRI looks like.
Nice, evenly spaced discs, solid (yellow) spinal cord with nothing touching it, bright white spinal fluid alllllll the way down the spine.
Now take a look at the MRI below…
Do you see where that nice fat white spinal cord & fluid is cut in half??
It looks like the Angel Falls in Venezuela!
This is an example of a Grade 4 spondylolisthesis.
You would be very reasonable to think that this 32 year old pregnant woman had IMMENSE amount of back pain-
…that she might be confined to a wheel chair for the rest of her life
…couldn’t sit
…stand
…walk
…jump
…not be able to play in the park with her child
…And definitely NOT play sports or compete as an athlete
But guess what?
She had absolutely NO symptoms!!
And this was from a fall 2 years prior to the MRI!!
Thats right, she goes about her life without pain, numbness, tingling or weakness.
AND she’s carrying another human inside of her!!
I am NOT making this up. Click this link to access the article
(She just needed a C-section when delivering to avoid complications)
That same review study in the link above and this study also discuss the following:
Of 60-80 year olds:
99% had at least one degenerative or bulging disc
Of 60 year olds:
36% had herniated discs
21% had spinal stenosis
>90% had degenerated or bulging discs
Of 20-39 year olds:
35% had at least one degenerative or bulging disc
AND THEY WERE ALL PAINFREE WHEN THEY TOOK THE MRI!
Another report shows that 84% of study participants had no change or an improvement in imaging after they developed back pain!
Take a look at a paper written in 2011 about the use of MRIs for diagnosis from a physical therapist perspective.
The authors found that the MRI results might make a patients perception of pain WORSE by increasing their fear of movement. This may result in weakening tendons, ligaments, muscles & even bone- driving them further down the rabbit hole with increasing their risk of other injuries.
Plan on having surgery after finding out what the MRI shows? Check out what these folks found:
“…use of MRI versus a lumbar radiograph early in the course of an episode of LBP resulted in a 3-fold increase in surgical rates, with no improvements in outcomes in the subsequent year.”
This is not to say that surgery should not be performed at all. Only that surgeries based on taking MRIs early in the pain experience provided no additional benefit.
In other words, unnecessary surgery.
I get it…
By now you might be a little hesitant, maybe even confused about what your next step should be.
I am here to assure you that despite what your MRI or x-ray shows, you and your body are more resilient & stronger than you think.
You just need to find the right path to take.
Learn techniques to alleviate pain with movement.
Exercise to maintain a healthy body.
Rethink your perceptions about what pain truly is and how your life is changed by it.
Absolutely. 110% you should not read this blog and make a decision for yourself without first having consulted with a medical professional. You need to consult with a qualified health care practitioner, probably a few.
Keep the team diverse.
Speak to medical doctors, athletic trainers, physical therapists, chiropractors, massage therapists. Maybe even a sports/performance psychologist if you are fearful of returning to sport or activity.
Developing a plan that you are comfortable with, after you have spoken with family, friends and professionals, is the best option.