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Why Your X-Ray Or MRI May Not Be As Helpful As You Think

X Ray of spinal column

As physical therapists, we often view the imaging results of of our patients.  

Many times, these images (X-Rays or MRIs) cause people to feel as if they are broken and need fixing.  

Maybe you have had an X-Ray or MRI that made you feel that surgery is inevitable, or that your pain is something that you will always have to deal with. Perhaps you are thinking that you are no longer capable of performing the sport you love, or exercising at a high level.  

X-Rays are used to gain information about bones and general information about joints. For example, the X-Ray of someone with lower back pain will give us information about how much space this person has between each vertebra, and if they have any fractures in their lower back. However, this will not provide information regarding the state of soft tissues (muscles, tendons, ligaments), or much information about intervertebral discs.    

An MRI, will give us much more detailed information. This image provides more specific information about the state of intervertebral discs, or damage to soft tissues.   Despite, all of this great and detailed information, many times it is not useful.  

Research shows that many of us have meniscal tears in our knees, labral tears in our shoulders, and damage to the discs in our lower backs, without any idea that these issues are even there!  

In other cases, people have X-Rays or MRIs for a painful area of the body, and nothing significant is found!  

In fact, research shows that 90% of lower back pain is non-specific. This means that according to images, we have no idea what causes 90% of lower back pain!   The moral of the story is that findings on images are not always correlated with the pain or the limitations that you may be experiencing.  

So, does the image even matter? In these cases, the answer is….not really.

This is not to say that images are useless. X-rays and MRIs are extremely useful when the findings coincide with the symptoms you are experiencing. The images and your symptoms should fit together and contribute to tell the same story.  

If you have had an X-Ray or MRI, take that with a grain of salt and understand that it is just one piece of the puzzle. A decision to have surgery, or another invasive procedure should not be made solely on the findings of an image.  

Even if an image shows a large amount of damage, it is still possible to feel great and remain active by addressing what caused the damage to build up in the first place! As physical therapists, and strength and conditioning professionals, this is of greatest concern to us. 

Damage does not accumulate in a tissue without a reason for doing so, and it is our job to figure out this out! If you have an X-Ray or MRI that is of concern to you, it may be most useful to figure out why these findings have occurred, and learn what you can do to address it! 

This will help you get out of pain and back to performing the activities you enjoy, despite what your X-Ray or MRI says!

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