“My neck hurts because I have a pinched nerve”
“I can’t lift weights anymore because I have a torn rotator cuff”
“I have chronic back pain because I have degenerative disc disease”
“I can’t squat anymore because I have arthritis in my knee”
Does this sound familiar? I know I have heard it all. I’m here to tell you, most of the time, it doesn’t matter. Don’t shoot the messenger, hear me out.
Not all musculoskeletal aches and pains require X-rays, Ultrasounds or MRIs. In fact, having that information could be detrimental to one’s rehabilitation. The simple fact is there are millions of people worldwide with no pain or dysfunction, with the EXACT same imaging results. Simply because you show a bulging disc, a muscle tear, arthritis or a meniscus tear does not always mean that is why you are in pain. In fact, those who have had imaging have more Doctor’s visits, less function, lower sense of well-being and longer lasting pain. Let’s take a look at the facts:
- Lumbar Spine:
- Lumbar disc degeneration is present in 40% of individuals under the age of 30 and present in 90% of those between the ages of 50-55.
- In healthy young adults with no back pain, 48% had at least one degenerative disc and 25% had a bulging disc.
- Leading Physicians at the department of Neurosurgery at the University of California strongly recommend against the routine use of MRI for low back pain because they have found no link between degenerative changes seen in MRIs or X-rays and low back pain.
- Bottom line: do not panic. Your imaging may indicate you have bulging discs or degenerative discs. These are simply normal changes that happen from age 20 onwards.
- Thoracic Spine:
- In healthy adults with no history of upper or lower back pain, 47% had disc degeneration, 53% had disc bulges and 58% had disc tears in their thoracic spine.
- A shocking 29% had a disc bulge that was actually deforming and pressing on their spinal cord.
- Bottom line: do not panic. Your imaging may indicate you have bulging discs or degenerative discs. These are simply normal changes that happen from age 20 onwards.
- Cervical Spine:
- In healthy adults and seniors with no neck pain, 98% had evidence of degenerative changes in their cervical discs.
- A 10 year study that compared MRIs of healthy people to those with whiplash injuries showed that both groups had similar MRIs both immediately and 10 years later, with 75% of them having cervical disc bulges.
- Bottom line: do not panic. The vast majority of healthy adults get neck degeneration (arthritis) and disc bulges as a normal part of the aging process. If these were the only reasons why people had neck pain, then 98% of people would have neck pain.
- Hip:
- 77% of healthy hockey players who had no hip pain had hip and groin abnormalities on their MRIs.
- Bottom line: do not panic. Having cartilage tears or narrowing in the hip joint are not signs of permanent pain or disability.
- Knee:
- 85% of adults with no knee pain have X-rays that show knee arthritis.
- 48% of healthy professional basketball players have meniscal damage on their knee MRIs.
- Bottom line: do not panic. If your imaging shows degeneration, arthritis or meniscus tears it is completely normal.
- Shoulder:
- MRI studies of adults with no shoulder pain show that 20% have partial rotator cuff tears while another 15% have a full thickness tear.
- 50% of individuals 60 or older with no shoulder pain or injury have rotator cuff tears that they did not know existed.
- 40% of professional baseball players have either a partial or full thickness tear of one or more of their rotator cuff muscles yet had no pain while playing and remained pain free even 5 years after the study.
- Bottom line: do not panic. Having a tear (even a full thickness tear) is not necessarily associated with shoulder pain.
- Ankle:
- 32% of people with no foot or heel pain have a heel spur visible on an X-ray.
- Bottom line: do not panic. Just because you have a heel spur does not mean that the spur is causing your foot pain.
What does this all mean? Wear and tear on your body is a normal part of life. There are millions of people worldwide with the exact same imaging as you with no pain. Your imaging report is not a death sentence nor are you confined to a life of aches and discomfort. Come to Physiotherapy near you and to discover the source of your pain and best of all, how to manage it independently.
49 of every 1000 people in Canada had an MRI performed in 2011-2012, which equates to roughly 1.7 million Canadians! An estimated 2.2 billion is spent annually on medical imaging, of which an estimated 220 million is spent on unwarranted imaging. Just because you have low back pain, burning leg pain, a stiff and sore shoulder that you can’t lift overhead does not mean you require medical imaging.
When is medical imaging required? Most often it is used to rule out a fracture following trauma. Common signs and symptoms of a fracture include severe pain, inability or unwillingness to move the body part in question, a significant loss of range of motion or inability to weight bear. If you are unsure if you have sustained a fracture, you should always go to the hospital. Medical imaging is also warranted if you are experiencing any of the following symptoms:
- Unrelenting pain that is unchanged with any position.
- Numbness/tingling/altered sensation in both legs, both arms or in all four limbs.
- Changes in bowel or bladder function (urgency, inability to void, loss of control).
- Numbness/tingling/altered sensation in groin.
- Unexplained weight loss.
- Numbness/tingling/altered sensation around mouth or face.
- If the outcome of the imaging is going to change the course of treatment (i.e. surgery, injections, bracing).
A Physiotherapist is able to diagnose what is occurring through a detailed subjective and objective examination. At the end of the assessment, a Physiotherapist can make recommendations on whether imaging is warranted. Most importantly, the Physiotherapist can start you on the path to regaining your mobility and function. Do not allow your imaging results to dictate your recovery.
Instead, take initiative and book an appointment to start feeling better.
If you need to figure out how to reduce your pain and increase your function to get back to your high quality of life, then give us a call at Beddington at 587.355.2738 and ask for Blake. He would be happy to restore your function and get you back to the results you want to achieve in your life. Whether it is lifting your children or grandchildren pain free or returning to your favourite activity, Blake is here to help you. call today!
References:
Advanced Physical Therapy Education Institute (2014). Concerned about your X-ray or MRI findings?: Prevent yourself from becoming a VOMIT (Victim of medical imaging technology). Retrieved from http://www.aptei.ca
Grant, K. (2014, February 18). Canadian doctors urged to limit testing to contain costs. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/life/health-and-fitness/health/medical-associations-to-urge-canadas-doctors-to-limit-unnecessary-tests/article16953492/
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How to Tell the Difference Between a Ankle Sprain and a Fracture.
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