Why getting an MRI may not be as helpful as you think…

Written By Dr. Jordan McCormack

“Do you think I need to get an MRI?”

“My MRI said I have bulging discs and degenerative disease in my spine! Should I be worried?”

“I had an MRI 6 years ago, I have 3 herniated discs. I have a bad back.”

“My physician told me my MRI was normal. So why am I having pain?”

Having spent the majority of my career helping people with spine related issues, I have heard some variation of the questions above more times than I bare to think about. Let me start off by saying, there are a number of instances where getting an MRI is very appropriate and needed to provide you with the appropriate care for your back or neck. HOWEVER, the frequency at which this is needed for your back or neck pain to be appropriately managed is much less frequent than people believe it to be.

To get past this part of the of the conversation early in this post, here are some of the common instances where getting an MRI would be appropriate:

  • Significant weakness of the arms/legs that is new and progressing — often seen as the physical inability to lift up your feet or make a firm fist

  • Urine retention or bowel incontinence — the inability to urinate with control or you are leaking your entire bowel movement with the inability to stop it

  • Numbness in your genital region — it may feel like a numbing shot was given to your groin area like you would get at a dentist office

  • Numbness/tingling in BOTH legs while accompanied by any of the above symptoms

If you are ever experiencing any of these symptoms, you don’t mess around. You should probably go be seen in the emergency department. That being said, often times an MRI can also be indicated when an honest attempt at conservative care — physical therapy, chiropractics, general exercise, diet control, etc — was given OR if symptoms are so severe that they are unable to tolerate conservative care. If this is the case, you should be consulting your local physician for guidance.

Now, if your symptoms do not fit any of these categories more often than not your healthcare practitioner does not need an MRI to provide you with the care that you need. In fact, recent research has even shown that unnecessary imaging can directly impact long term recovery due to unnecessary fear and uncertainty with the problem you are navigating. Science has shown us repeatedly that individuals with no pain who are imaged via MRI have the same types of findings as those individuals with pain. These types of findings include: disc degeneration, joint arthritis, bulging or herniated discs, and the list goes on…

This was an excellent instagram post put together by Tony Comella (@tony.comella) which demonstrates a combination of studies showing the types of findings that can be seen on MRI’s of people with no pain at all.

An important thing to understand about imaging techniques like an MRI is this — the scan only shows your anatomy. It does not show us how you move, the postures/positions/habits that you have during the day, or the pain you are experiencing. Your pain experience is much more intimate than a structure shown on a picture. In many cases, your physical therapist is going to look to hear your story to understand the history of your injury/pain, your beliefs surrounding this experience, how you move, and what your health habits are like to best determine how to help you. None of these specific details are provided on an MRI image and are often much more impactful in determining your overall trajectory for recovery.


So if getting an MRI often is not very helpful with managing back or neck pain — what is important? The simple answer for the majority of people is this: movement. Your body is designed to move and be challenged. Quite often when someone experiences pain that impacts their ability to move, exercise, or do an activity they enjoy a level of fear and uncertainty sets in.

“Should I stop doing this activity?”

“Is doing this movement/activity going to damage me?”

“Maybe I should just rest — I really don’t know how to navigate this.”

Do you resonate with this thought process?

Thought processes like this can lead to uncertainty causing inactivity, being hesitant or fearful of movement, and are often less productive with getting you going in the direction of recovery. If you are dealing with back or neck pain, the BEST thing you can do is find tolerable ways to move more rather than moving less. When your body moves and is pushed towards its tolerable limits, it does amazing things by adapting to the stimulus that you give it. These adaptations and changes are what facilitate healing both in your body and brain.


If this is an experience that resonates with you, that you are currently navigating, or know of someone going through this then find a physical therapist to work alongside you to get you on the path to recovery. Connect with us today so we can help you start your journey to a full recovery so you can get back to moving, get back to exercising, and ultimately get back to the activities you love most in life. Don’t let pain and fear hold you back any longer.

Citations:

Dr. Jordan McCormack

Previous

Navigating Back Pain: 3 Tips for Working from Home
Next

Understanding Your Symptoms: Mechanical vs Inflammatory Pain