With some injuries your doctor or therapist may suggest imaging to help rule in or rule out certain pathologies. These images can provide useful information but they can also present findings that may be misleading.
Your scan may show a bulge, degeneration, arthritis, osteophytes, or tears, to name a few, but the presence of these findings does not necessarily mean they are the cause of your pain.
A study done on the spines of healthy, pain free subjects showed that 50% of subjects in their forties had disc bulges and close to 75% had disc degeneration. By the age of eighty close to 100% of subjects showed disc degeneration.1
Another study demonstrated that ‘abnormalities’ in the knee also increase with age. Over the age of fifty, most knees showed signs of arthritis (osteophytes and cartilage damage), and this was true whether the subject had knee pain or not.2
Rotator cuff tears in the shoulder are prevalent in asymptomatic individuals at such a high rate that they are beginning to be considered normal signs of aging.3
So what does this all mean? It means that if abnormalities are seen on an image it is difficult to say whether they are new or if they existed before you started experiencing your pain. It means that an image can be a useful tool to visualize structural changes but that it shouldn’t always be taken at face value.
As practitioners we treat the individual and not the image. We use our assessment techniques and your individual story to help us determine the best course of treatment for you!
- Brinjikji, W., et al. (2015) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. Apr;36(4): 811-6 ↩
- Guermazi, A., et al. (2012) Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study. BMJ. 345:e5339 ↩
- Teunis T (2014) A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. Dec;23(12): 1913-21 ↩