Do you really need an MRI?

Recently I have noticed an increased number of patients asking me whether they need an MRI scan. Most of the time my answer is no, here is why:

Magnetic Resonance Imaging (MRI) is a way of picturing the inside of the body. The machine uses powerful magnets and radio waves to accurately image the body, it is able to distinguish between different tissues, so therefore will show any problems in the soft tissues of the body (unlike an x-ray). An MRI is excellent for showing what is physically there however it tells you nothing about how the body is actually functioning. 

This table shows that many 'pathologies' are actually a normal finding on MRI scans: 

Source:
W. Brinjikji et al, 2014. "Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations". AJNR Am J Neuroradiol. 2015 Apr; 36(4): 811–816.

These findings were taken from people with NO pain. A whopping 52% of people over the age of 30 show signs of intervertebral disc degeneration but have no pain, how can this be? 

The presence or absence of anything physical does not equal pain or no pain. This is due to the nervous system. Our bodies contain the most powerful computer in the world, that is capable of making us feel pain in the absence of a physical problem e.g. phantom limb pain and, conversely, we may feel no pain in the presence of physical damage e.g. the table above. 

This is possible because the nerves at the site of the 'damage' may or may not be sending signals to the brain telling it that there is a problem and the nerves in the brain may or may not be activated without stimulus from the site of 'damage'. 

Of course there are many people who do have pain and do have physical findings on an MRI. But what is much more important to me and most other osteopaths is how the person functions. We are able to tell this by taking a thorough case history, performing an examination and monitoring progress through a treatment plan. Therefore unless someone is showing signs that they may need surgery then most of the time I do not recommend that they need an MRI. 

Finally if you have had an MRI and it shows any of the findings above in the table remember that this does not mean that you have to live with the pain; if you improve your function and decrease the pain producing nerve signals to your brain then there is no reason why you cannot recover. There are many different types of therapists who could help you, including myself! 

So stop living with pain and get in touch!

Rockingham Forest Osteopaths

07977367222