Modern imaging technology has become increasingly prevalent in the medical industry but has failed to consistently identify the source of chronic, and especially spinal, pain.
It is therefore prudent for patients and their medical practitioners to have the appropriate insight when interpreting results from such technology and the extent to which they may be contributing to one’s symptoms, if at all. The decision to have surgery should therefore be based on more than pain and imaging alone.
We have previously assumed the connection between a person’s symptoms and their imaging findings but we’re now acknowledging more and more, how inappropriate that assumption has been; how ‘normal’ for one person and ‘normal’ for another person isn’t the same thing; and that nobody can say for how long your current findings on imaging (what we see on the MRI or x-ray) have been there for, or if it’s even linked to the symptoms which drove you to have an investigation done. Either one can be present without the other so rather than assuming that the investigation results explain the pain, we are being forced to acknowledge that those changes may purely be a result of your changed movement patterns, even to cope with the pain… Your way of compensating may be the only reason why we’re seeing ‘abnormal’ elements in your imaging or they can be completely unrelated.
Several high-quality research studies have already shown the disconnect between chronic pain and what we see on imaging. Degeneration of the joints and discs (including disc bulges and prolapses) have been confirmed to be a normal part of the aging process and does not correlate well with the presence or the absence of pain. Chronic pain may therefore rather be blamed on the movement patterns a person adopts over time rather than blaming what your images show. And often, surgeries may be addressing symptoms only… or nothing at all?
The frequency of degenerative findings on MRI/CT-scans of people without any back pain, ranges from 37% for people in their 20s, up to 80% for those in their 50s and as much as 96% when you’re in your 80s! Similarly, bulging discs, are seen in 30, 60 and 84% respectively, for pain-free individuals, in their 20s, 50s and 80s.
I wonder how many years it will take for us to start seeing a decline in the number of surgeries for chronic pain… How long will it take before we recognize that chronic changes on MRI are typically unrelated or a mere symptom? In the meantime, I’ll aim to see the disconnect and help individuals to do the same within themselves and their symptoms; to regain pain-free function and independence without surgery, unless it’s justifiably indicated.
Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.