In episode 68, Dr. Aaron Horschig breaks down why you shouldn't place your complete trust in MRI results for low back pain. Research has estimated that almost a third of healthy pain free 20-year-olds currently have a disc bulge in their spine! (Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015;36:811-16)
This number increases 10% every decade, meaning 45-50% of people between the ages of 40-50 have a disc bulge but with no back pain at all. It is highly likely to have abnormal scary findings on the MRI if you’re above the age of 60 but many of these individuals have no low back pain at all.
Can a disc bulge create back pain? Sure. But just because there is one that is picked up on an MRI does NOT necessarily mean it is the root cause of your pain.
Check out these referenced articles:
Jensen MC, Brant-Zawadzki MN, Obuchowski N, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69-73
Carragee E, Alamin T, Cheng I, et al. Are first-time episodes of serious LBP associated with new MRI findings? Spine J. 2006; 6(6):624-35
Fukuda K & Kawakami G. Proper use of MR imaging for evaluation of low back pain (radiologist’ view). Semin Musculoskelet Radiol. 2001;5(2):133-6
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