“So my MRI said____”
Let’s paint a picture for you. You’ve been dealing with an new injury or have been managing some nagging pain for some time. You decide to reach out to your doctor or healthcare provider to make sure everything is okay. Your provider decides to order some imaging, whether that be an X-Ray or MRI, and boom… the diagnoses are thrown at you. You have “degenerative disc disease”, “osteoarthritis”, your joints are “bone on bone”, you have a “bulging disc” or my personal favorite, your spine is like “the back of an 80 year old” even though you’re 30. Immediately you’re wondering, do I need surgery? A cortisone injection? Do I need to give up running/weightlifting/high impact activities forever because they’re “bad for joints”?
Unfortunately this scenario happens much too frequently in healthcare, and many are left to wonder if they should drastically change their active lifestyle or choose to undergo invasive and/or expensive procedures as a result. However, what if you knew that a majority of asymptomatic people, meaning experiencing no pain whatsoever, have “abnormal” findings on imaging? Let’s take a look at some of the evidence:
A systematic review found that 97% of asymptomatic individuals showed abnormalities in at least one structure in their knee on MRI, all with varying grades of severity. Findings ranged from meniscal tears, bone marrow edema, osteoarthritis and cartilage abnormalities, and tendon and ligament abnormalities.¹
Brinjikii et. al (2015) found that a high majority of pain free individuals had positive spine findings on imaging in ages ranging from 20-80 years old. Disk degeneration was as high as 37% in asymptomatic 20 year-olds.² Think about that.
In addition, there is evidence that positive findings on imaging (X-Ray, MRI, Ultrasound) are not significant between symptomatic and asymptomatic shoulders of the same individual. Meaning if your painful shoulder has abnormal findings, it’s highly likely that the other pain free shoulder has them too.³𝄒⁴
So what does this mean? It means that an “abnormal” finding may not be serious or debilitating. It means that you are not damaged or broken. Here at The PATH we are firm believers in the fact that the human body is highly resilient and adaptable. We put our bodies through varying stressors and loads throughout life, and our bodies have the right to adapt to them accordingly. Whether those adaptations express themselves as tendon/ligament changes, joint changes, disc changes, etc., more often than not it’s not harmful. If these changes are present and painful, they can easily be managed conservatively with the right team and guidance. If you’ve been dealing with some nagging pain, or are worried about potential findings on imaging, give us a call or shoot us and email to get in contact with one of our Doctors. Let The PATH get you back to the things you enjoy, because you deserve more than the status quo.
References:
Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol 49, 1099–1107 (2020). https://doi.org/10.1007/s00256-020-03394-z
Brinjikji W, Luetmer PH, Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015 Apr;36(4):811-6. doi: 10.3174/ajnr.A4173. Epub 2014 Nov 27. PMID: 25430861; PMCID: PMC4464797.
Barreto RPG, Braman JP, Ludewig PM, Ribeiro LP, Camargo PR. Bilateral magnetic resonance imaging findings in individuals with unilateral shoulder pain. J Shoulder Elbow Surg. 2019 Sep;28(9):1699-1706. doi: 10.1016/j.jse.2019.04.001. Epub 2019 Jul 3. PMID: 31279721.
Gill TK, Shanahan EM, Allison D, Alcorn D, Hill CL. Prevalence of abnormalities on shoulder MRI in symptomatic and asymptomatic older adults. Int J Rheum Dis. 2014 Nov;17(8):863-71. doi: 10.1111/1756-185X.12476. Epub 2014 Oct 8. PMID: 25294682.
Dr. Paulina Tselikis
Co-Owner
PT, DPT, ATC, USAW-1
