Imaging, such as x-ray and MRI can be useful, but it can also be of no use and potentially harmful at times.
Whether it be for the neck, back, knee, hip or some other part of the body, scans often do show up some abnormalities but the important thing to find out is whether that is relevant.
Abnormal findings are normal
Just because a scan shows an abnormality, that does not mean that it is the cause of your pain at all. This can be a tough one to believe but it is totally true. Changes to our joints, discs and ligaments area normal part of living. Check out the image below thanks to Adam Meakins:
As you can see, a huge proportion of the health, pain-free population has “abnormal findings on scans.
These findings are so common that they should really be called normal findings!
So how we know if they are relevant?
Imaging is a useful and important part of managing some injuries but only when called for, when there is a lack of improvement or red flags present. Only then wills further investigations are called for.(1)
Results from imaging are not the be all and end all but can help for a clearer picture of an injury when needed. This is done by putting your scan findings together with you clinical presentation (your pain presentation, aggravating factors, physio assessment etc). A health professional, such as a Physio or Doctor can put this together to form a clear idea of what if any scan findings are relevant.
All this can help explain why often a lot of people don’t get better when treating things that show on scans. Bursitis in the shoulder, for example, shows a lot on ultrasound scans and is too often injected with cortisone with only short-term improvements as this isn’t fixing the underlying issue that caused secondary bursitis.
Every case is different and individual. Hence why a thorough assessment by a musculoskeletal expert (a physio) is important and the whole picture is looked at. Don’t freak out if a scan shows degeneration or arthritis – often it is surprising to not show that!
If in doubt, come and get it checked out to get a clearer picture of what is going on and importantly. why.