I know you have been here before. Your back or butt hurts and it’s been a long time, and you finally go to the doctor. They order and x-ray or an MRI and you anxiously await the results, thinking that they will be giving you a reason for you increasing pain.
The results come back and your doctor doesn’t seem concerned. They tell you that you scans are normal and shrug and suggest you try physical therapy, again.
or
The scans come back and show you have arthritis, or disc degeneration, or a small tear, or maybe a little stenosis. You feel vindicated, your pain is named, your ready for solutions and an end to your physical torment. Over time, you realize the treatments you were given for these findings are not working and your pain continues.
In both cases people tend to flock to facebook groups, wanting reports or imaging read, by untrained strangers, trying to find answers. I’m going to suggest this is a terrible plan. I’ve seen so many terrifying answers given by people who are untrained but well-meaning. If you have questions about your results, please ask your doctor, not random strangers.
You guys, pain can not be seen on a scan. If you have been hanging around me at all, you have heard me say, pain is multifactorial. that means no one thing “explains” it. Spinal findings are often incidental and zooming in on these findings is often a great way to stay in pain.
This seems like a great place to remind you that sometimes scans are needed. Red flags should always be ruled out, they can be found here. But the reality is, when it comes to everyday Lowe back pain without red flags, imaging is just not advised, or needed!
Why would I say something like that? Because of the following:
- Scans don’t explain pain or recovery.
- Scans don’t show the amount of pain you feel.
- Scans can’t tell you about future pain.
- Scans don’t show your ability to live within your life.
- Scan findings will not change your treatment plan.
- Scans DO show age-related changes, ( wrinkles on the inside)
- Scans DO show things that were there before your pain and will be there long after.
Ever notice you can have a low pain day or a few days or weeks with no pain? Have you thought about the fact your imaging results didn’t[t change when you had those pain-free or low-pain days? It’s true.
“There is a high prevalence of ‘abnormal’ findings on MRI in pain-free populations: disc degeneration (91%), disc bulges (56%), disc protrusion (32%), annular tears (38%).” Professor Peter O’Sullivan, PhD
That’s a lot of abnormal findings within people that do not have pain!!!! We really really need to think about that when it comes to our imaging results. Most often people see these findings as sentences for forever pain. We know that isn’t true!
In 2016 a study of Olympic athletes was completed. Researchers were curious about the prevalence of disc degeneration in these athletes. Know what they found? Bet ya can’t guess.
“Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines.”
Crazy, isn’t it? There are zillions of studies on how things like;
Arthritis, DDD, Stenosis, slipped disc, bulging disc, hip impingement, labral tears in the shoulder and the hip, rotator cuff tears, and knee arthritis – these are all found in people with and without pain in high frequencies!
No wonder surgeries to “fix” these imperfections don’t always work to eliminate pain.
In 2007 the American College of Physicians and the American Pain Society pointed out the futility of MRI in their guidelines for the management of low back pain. The wise use of MRI is great, but the common overuse and abuse of MRI is a disaster of over-medicalization.
Low back pain experts have long understood that you simply cannot reliably diagnose low back pain with MRI or with X-ray in isolation and trying to do so reliably raises false alarms that actually do harm. Ordering MRIs too soon is actually often worse than useless, scaring patients badly and doing real harm.
I know this sounds harsh, but I say it with hope and love! It’s actually good news.
Now that you know scans can’t show your pain and that they are not advised without red flags, I hope you will be less frustrated with your providers.
Remember, your pain is real – always. You are never making it up. You also don’t need to have something on a scan to heal. Moving Beyond your chronic pain is always possible, and even easier when you don’t have much to show on scans!
Put your worries down, there is so much more to chronic pain than a picture. Book a FREE 30 min consult with me and let’s talk about how pain coaching can help you with your pain.
For a little more on scans, check out my YouTube video on why no news is good news!
