When we experience pain, we want to identify the cause of the pain to effectively manage symptoms and treat the underlying cause. As physiotherapists, subjective and objective assessments can be completed to help us gain a clearer an idea of what is leading to you experiencing pain. However in some cases, patients can be referred for investigations, such as MRI Scans, to help identify these causes.
So why doesn’t everyone with pain just go get a scan?
If we were to scan everyone, it is likely that the majority of people will have a positive MRI scan diagnosis. This is because our bodies are undergoing normal changes as we age and undergo day-to-day stresses. Studies show that even though a number of people have a positive MRI finding- the majority will not experience any symptoms! Additionally, there is a poor relationship between pain and positive findings, therefore the result of the scan may or may not be related to why you are feeling pain.
Understandably, receiving a positive diagnosis, such as a bulging disk or tear, can be intimidating. A number of patients who enter our clinic are concerned and worried about “doing more damage” or “their back is forever damaged”. These worries and or pain focus can actually lead to more pain!
This is because pain is our interpretation of the signals carried by nerves from the body to the brain. By focusing on pain or a MRI diagnosis we are increasing signals to the brain impacting our ability to filter pain signals. Additionally, this fear of causing more harm can result in fear of movement leading to increased stiffness and tightness in the area, increasing pain when moving.
This is not to say that investigations are not important- but rather they are just a piece of the puzzle in your rehabilitation. It is therefore important remember that findings are not necessarily the cause of pain but rather pain is multi-dimensional and can have a number of contributing factors.
If you have any questions or concerns about your pain management or MRI findings- book in to speak with a physiotherapist today!
By: Tara Moore
References
“Body Image based on Tony Comella (@tony.comella) based on Twitter by Jørgen Jevne (@jevnehelse).”
Tony Comella. Instagram post @tony.comella. Dec 16, 2017
Cervical: Nakashima, H et al. Spine (Phila Pa 1976), 2015.
Lumbar: Brinjikji, W. et al. AJNR Am J Neuroradiol, 2014.
Knee: Beattie, K.A. et al. Osteoarthritis Cartilage, 2005.
Shoulder: Schwarzburg, R. et al. Orthop J Sports Med, 2016.
Hip: Register, B. et al. Am J Sports Med, 2012.”
Association MRI findings and back pain: Tonosu, J. et al. PLoS ONE , 2017
Fear and pain levels: Sullivan, M.J. et al. Clinical Journal of Pain, 2004