MRI's are not the be all, end all

9 June 2016

MRIs and other investigative options (CT, x-ray, ultrasound etc) are great, there's no doubt about it, but lately there have been some thoughts as to how relevant to your pain a lot of the results are.  While it's easy to draw a conclusion that someone with low back pain and an MRI that shows a 'disc bulge at L4/5' is getting this pain because of the bulge, this is likely not the case.

There have been a lot of studies of late on this topic. One that comes to mind is a study by McCullough et al (2011) that looked at people with no complaints of low back pain and performed MRIs on them. 91% had disc degeneration, 64% had disc bulges and 38% had an annular tear (a disc rupture!). But no pain!

Our job at AAP is to work out if the scan results are relevant given your symptoms. A 'disc bulge' is something that can strike fear into even the most stoic of patients, but a lot of the time the pain won't be coming from this bulge, and if it is we are great at working out why this disc has been overloaded.

While scans will help to create part of your picture, just remember that it does not necessarily define your pain or dictate your recovery time. 

Disc bulge.png

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