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If you have lower back pain you probably have an MRI of your lumbar spine. Or are trying to get one. An MRI of your spine will inevitably show something “wrong.” A herniated disc, bulging disc, protruding disc, disc degeneration, annual tear, etc. The list is long. Patients and healthcare providers alike focus and fixate on these findings. The general approach is to chase the pain. You choose the structures said to be “abnormal” on your MRI and set about to “fix” them. This usually results in an incredible amount of money and time spent seeing specialists. If the pain doesn’t eventually go away or get better people become more frustrated and confused. This is basically the approach to lower back pain treatment in modern medicine.
Does your lower back MRI really matter that much?
Not as much as you think. The medical literature has shown that many of the findings are incidental and difficult to blame pain on. In addition, as a person ages the incidence of bulging discs, disc degeneration, and annular fissures increases. IN PEOPLE WITHOUT low back pain. Check out the research. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.
When people without lower back pain develop lower back pain more than 80% of them have unchanged or IMPROVED MRI findings.
These are people without lower back pain who then developed lower back pain. MRIs were taken before they had pain. Then taken again after they developed lower back pain. Even with the development of lower back pain new MRIs did not show any “smoking guns” in 84% of the cases. Are first-time episodes of serious LBP associated with new MRI findings?
So how important are the findings on your MRI? Not as important as you think.
Certainly not important enough to base your entire treatment on. I know this sounds counterintuitive, but it’s the truth. MRI findings that we consider abnormal in people with low back pain are found in people WITHOUT low back pain. And these findings increase in incidence with age. They can be viewed more as normal, age related changes. Not problems that must be fixed. Yes, the bulging disc can cause back pain. But don’t focus and fixate on the bulging disc. Focus on doing what we know works to decrease pain and improve function. This will result in a better outcome compared to chasing the pain.
Your Lumbar MRI…How Important Is It? Is a more in depth article that covers more of the research and statistics as they pertain to lower back pain and MRI findings.
