An MRI, or Magnetic Resonance Image, is a diagnostic tool that is used to take an image of a variety of structures such as the heart, internal organs, or brain tissue just to name a few. In the world of orthopedics, it is used to take a look at tissues such as bone, nerves, muscles/tendons, ligaments and much more.
Although an MRI can be very useful in diagnosis, there are some drawbacks. For example, when looking at back pain, MRIs don’t always tell the whole story. A 2013 research article took a look at back images of over 3,000 people who had no back pain or symptoms at all. Of these asymptomatic people, 80% who were over 50 years old had images that showed disc degeneration, and 60% in that age group had a disc bulge. Even in the younger groups, 37% of 20-year-olds had disc degeneration and 30% had disc bulges.
You may be asking, so what do all of these stats mean? They mean that sometimes, the picture doesn’t tell the whole story. There are times when the image doesn’t match the pain, so sometimes getting an MRI can do more harm than good.
Let’s continue to use that back-pain example. If somebody has back pain with activities such as picking up a weight from the ground or squatting, it can be due to a variety of issues. This person may just need a core strengthening program in order to stabilize their lower back when they are active. If they have an MRI done first, there is a high probability that the image would show some underlying degeneration or abnormality. This may lead them down a path of treatments such as injections or surgeries rather than the strengthening program that they need. They may even be afraid to move or exercise, which could cause other health issues such as weight gain, and poor cardiovascular health.
MRIs and images do have their place in healthcare. They are very useful for ruling out more troubling conditions, or to take a deeper look when somebody isn’t responding as expected to conservative measures such as PT, anti-inflammatories, or corticosteroids. MRIs are certainly an important piece of the puzzle, but not always required.
Physical therapists don’t order or perform MRI’s, but studies show that therapists are a safe choice as a primary provider for aches and pains. Physical therapists are able to obtain a thorough history, palpate, and perform screening tests that cue them to a deeper issue. Physical therapists can differentiate whether you will need conservative care or have an issue that might require an MRI or a referral to a specialist. If one of those findings is present, they would refer you to the proper provider so that you can get the care that you need and is appropriate for you.
If you have any questions about this post or would like to speak with a physical therapist about an injury, give us a call at (978) 263-0007. We would be happy to answer any questions and discuss possible next steps.
Achieve Physical Therapy is currently open in Acton, Bedford, and Sudbury MA. We can see you in the office or by video treatment. If you choose to come into the office, we are following all CDC guidelines including the use of face coverings, cleaning, personal hygiene, and staggering patient appointments to limit how many people are in the office.
