I want an MRI
This slide from the recent 2016 Sports Medicine Australia Conference is very confronting for a health professional and should be a concern for patients with low back pain.
It indicates that those that have an early MRI potentially have longer disability with low back pain, have increased medical costs and more of a chance of having surgery.
Perhaps it is because having an MRI unveils some degenerative changes that may or may not be related to your symptoms and then unfortunetly that sets the wheels in motion for further more invasive management that may not be warranted.
Yes an MRI is a powerful piece of technology we have at our disposal these days to investigate certain musculoskeletal conditions, however sometimes it opens a can of worms that prevents patients improving as they have an image in their head about how fragile their back is....
Most degenerative changes of the spine are like grey hairs or wrinkles, it is a natural part of ageing and not the primary concern for your back pain. MRI reports can indicate disc degeneration, bulging, height loss, protrusion and annular tears and all of these sound terrible, BUT a lot of patients with no back pain have been scanned and have these very same results on an MRI report, so just because they are there, does not necessarily mean it is the root of your pain. An MRI should be used in conjunction with a good subjective and objective examination to deduct whether or not these elements are a factor of your pain. To just use the MRI as evidence is useless. Some of my patients may of heard me talk about the 'stiff door hinge' scenario when it comes to scan results. For instance, I can feel stiffness in your spine and see stiffness when you move but an MRI can not, and I relate this to a 'stiff door hinge'. If I took a picture of a stiff door hinge, from that picture would you be able to tell me if it was stiff and in what direction? Probably not.........
Trust your health professional and their expertise and treatment rather than a picture. Your therapist can see you move, feel your muscles and joints and test your strength and function and that is something an MRI is yet to do. Your therapist will order an MRI investigation at the right stage of your treatment.