When a person suffers from a musculoskeletal problem, it can sometimes be useful to use medical imaging techniques to get a better overview of the problem and plan appropriate interventions. However, it is not uncommon for health professionals to use an imaging technique (magnetic resonance, ultrasound, X-ray, etc.) while it was not necessary to do so. Therefore these expensive technologies become overused and the public is left with some troubling information about the status of their musculoskeletal system without fully understanding their implications.
In the medical field , the different imaging techniques are useful for identifying serious conditions such as fractures, tears, injuries to the spinal cord , etc. However, once these conditions rather “serious” were excluded by the physician, it was not shown that medical imaging tests are sensitive enough to explain the majority of discomfort and pain felt by the patient (1). The results of these tests should then be considered with caution. It is importnant not to become a victim of medical imaging because it means more doctor visits in the future, more long-term pain and a decrease in well -being.
In a physiotherapy clinic, it is not uncommon to receive a patient with magnetic resonance imaging results (MRI) showing multiple herniated discs in the lumbar region, or pinching of a nerve root with narrowing of the channels in the cervical vertebrae. The patient feels so distraught thinking that his problem can be repaired only with surgery and arrives at the clinic with the idea that the problem can not be resolved by physiotherapy. This is completely false! Of course, each case is different and each patient needs to be assessed carefully to determine which way the problems can be worked in physiotherapy.
Take the example a patient that complains of pain in his/her lower back. When performing the physiotherapy assessment, the physiotherapist will want to assess the amount of movement available in the spine, if stiffness is present, if muscles are tense or inflexible, etc. All these things can be handled by different physiotherapy techniques , and without the need to have medical imaging results. If necessary, the physiotherapist can make a reference for further testing to adjust treatment or refer to a specialist.
Another frequently seen in clinical example : a patient presents with neck pain radiating to his right arm. He/she undergoes a MRI and the results show a moderate to severe disc herniation between C6 and C7 (6th and 7th cervical vertebrae) on the left. Despite that there is indeed an anomaly that was detected by the MRI, it does not explain the patient’s pain in his right arm, the hernia is on the left!
In short, you have to be careful with imaging tests and you need to avoid becoming a victim of the results of these tests. While useful for diagnostic purposes, the results are not predictive of results following therapy with a physiotherapist. Osteoarthritis, changes in soft tissues ( discs, ligaments), to bones in the spine, and joints are unfortunately normal with aging and do not equal pain and incapacity !
If you have any questions regarding your imaging results, think being a victim or want to avoid becoming one, please consult a healthcare professional who will guide you and reassure you !
Andrée-Anne Lorrain M.Sc. pht