80-90% of Americans experience some aspect of low back pain at some point in their lives. For anyone that has experienced this, myself included, it can be an extremely disabling and scary. But the good news is that our bodies are incredibly resilient and have the capability of healing themselves even with debilitating issues.
Many structures in the spine have the capability to generating pain when injured such as muscles, tendons, ligaments and discs. In the United States a typical course of action after a back injury is to order advanced imaging such as an X-ray or MRI in an attempt to find out the cause of the pain. But how accurate is more advanced imaging in diagnosing the cause of the back pain? A high percentage of people without any back pain have abnormal findings on their MRIs. In fact in order to directly associate findings on an MRI with someone’s pain, specific signs and symptoms must be identified by a healthcare provider in order to make an accurate diagnosis. So the good news is when you hear things such as degenerative disc disease, osteophytes, arthritis, and foraminal stenosis you are not alone. In fact you might be abnormal if you don’t have these findings!
With that being said, when should an imaging study be performed? If you notice numbness or tingling going down into your legs, pain which came about without an injury associated with it, and if you are older with a history of cancer, imaging studies are advocated. A thorough exam including subjective history, neurological exam, movement analysis and functional assessment must line up with your findings in order to make a clinical judgement regarding care. As always, finding information on the internet should never be done in place of seeing a clinician to make a diagnosis and determine when an imaging study needs to be done. But for the vast majority of us, these findings are normal wear and tear from aging. If you would like to learn more about this topic and what are the best current evidence based treatments for back pain, keep your eyes open for an upcoming seminar this summer at Specialized Physical Therapy in Candler.