The Pain Truth: MRIs & Low Back Pain
While this may sound surprising to you, the reality is that there are very few cases in which getting an MRI will successfully aid in treating your low back pain.
If you have had an MRI and tried to read the results yourself, it can be very confusing. You will see many scary terms like degenerative, spondylosis, spondylolisthesis, and facet narrowing, just to name a few. This will alarm any person, even if they have no low back pain...actually, ESPECIALLY if they have no low back pain! However, the reality is there’s not much to be worried about because most of the population with no complaints of low back pain will also have these findings.
Systematic reviews have estimated that the annual incidence of LBP in Americans is as high as 33%. Many of these people will see a physician who will recommend getting an MRI. In most cases, this recommendation can do more harm than good for getting rid of your low back pain. Why is this? Many studies show that receiving an MRI makes you more likely to end up seeking relief from injections, medications, or even surgery.
This may all sound frustrating, but it is important to note that a high percentage of low back pain is non-specific. This means that healthcare professionals cannot pinpoint one specific structure to be the cause of your low back pain.
“Then what is causing my pain?”
That’s a great question, and we hear it all the time. Due to the complexity of the human body, a person’s pain is multifactorial, meaning many factors play a role in your pain – including daily posture (sitting vs. standing), joint mobility in the hips, low back, and upper back, poor workout mechanics, joint instability, weakness, lack of coordination, nutrition, sleep, stress, and personal experience surrounding low back pain.
You’re still probably wondering, why does the MRI show so many things “wrong” with my back? The truth about these expensive imaging techniques is that their findings are not strong predictors of symptoms. Here is a table that summarizes the MRI results in people without any back pain.
The problem is that when your physician orders an MRI, they are assuming that the findings are the cause of your pain. Yet, as shown above, just because you are in pain and the MRI shows abnormalities, these abnormal findings may have been there for years without you even knowing and thus cannot be attributed to the pain you are having now.
There are, however, some instances when an MRI is warranted and should be done right away:
A HISTORY OF CANCER
UNEXPLAINED WEIGHT LOSS
LOSS OF BOWEL OR BLADDER CONTROL
LOSS OF MUSCLE POWER OR FEELING IN THE LEGS
Now that you’ve learned the pros and cons of an MRI, use the results as a tool to guide your conservative treatment and be an advocate for your low back pain journey. Research shows that the #1 predictor of whether your low back pain will improve is if you think your back pain will improve. And believe it or not, 90% of low back pain will recover with conservative treatment such as physical therapy.
When it comes to treating low back pain, physical therapists don’t actually care about the results of your MRI. We like to say, “the mystery is in the history.” We care more about how your low back pain began, how your pain has changed over time, how your body moves now, your return to function goals, and how we can provide a solution to your problem. Having an MRI will not determine or change our treatment plan.
The next time your physician suggests getting an MRI (for all conditions, not just low back pain), be sure to ask if it is necessary and how/if it will change your treatment plan.
If you have had an MRI and are unsure of your next course of treatment, let us help. We’ve worked for over 20 years helping people become pain-free again so they can get back to the things they love. Our team is composed of experts in treating all types of low back pain safely and effectively without the need for expensive medical procedures. Reach out today at firstname.lastname@example.org or 404.907.4196.
Thanks for reading,
Lauren Sok PT, MPT
Fearless leader and mother of the team, Lauren took the leap to found Functionize in 2015 after nearly 20 years in conventional physical therapy practice with the ultimate goal of creating a new legacy for her family and her colleagues.
encouraging and enjoying an active lifestyle; as a result, she grew up watching them age
Finding energy in helping others and joy in watching them succeed, Lauren embraces childish enthusiasm and overt optimism in the face of entrepreneurship. Despite doubts and challenges, Lauren braved starting a cash-based physical therapy practice at a time when private-pay was a novel concept in the healthcare industry.
Raised in a small, blue-collar town in Pennsylvania, Lauren grew up with her parents constantly with grace and agility, which became a prime motivation for her to help others do the same. Lauren came to learn that a proactive approach to health and wellness is the key for living your fullest life. The first in her family to go to college, Lauren laid the foundation for Functionize in hard work and determination.
To create the dream team, Lauren carefully curated a culture comprised of dynamic, invested and innately curious experts in relentless pursuit of providing best-in-class care and a customized approach for each individual patient.
Lauren’s intention is for her clients to feel they have a coach, partner and friend in with Functionize. Her goal is to ensure every person who comes into the Functionize fold leaves the education, support and empowerment to regain control over health and optimize wellness. Ultimately, she is dedicated to disrupting the current approach to healthcare for one that focuses on humans as a whole as opposed to the sum of symptoms.
Today, Lauren lives in Dunwoody with her husband, Kevin, teenage twin boys, Ethan and Austin, and spunky daughter, Sienna. When she is not running between sporting events, networking socials, supper clubs, carpooling, and school volunteering, Lauren enjoys traveling, running, a lazy day on the beach, OrangeTheory Fitness, and exploring the food and events in Atlanta, GA.
“Beginning Low Back Pain Treatment With Advanced Imaging Leads to Higher Total Costs”, choosept.com
Delitto A, George SZ, Van Dillen L, et al. Low Back Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. The Journal of orthopaedic and sports physical therapy. 2012;42(4):A1-57. doi:10.2519/jospt.2012.42.4.A1.
Brinjikji, W, Luetmer PH, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.