This article will discuss one of the most misunderstood areas in all of spine care: diagnostic imaging.
Diagnostic imaging refers to tests such as x-rays, CAT scans and magnetic resonance imaging (MRI). Many of you have had some or all of these tests. You may have been told you had an abnormality. Were you also told that such an abnormality may have NOTHING TO DO WITH YOUR PAIN?
Studies of normal adults who have NEVER had back or neck pain have shown that up to 40% will have abnormalities on imaging studies (References 6,7,8). The implications of this fact are very important. It means that these tests are not very good at distinguishing normals from abnormals. Furthermore, it means that if a person develops back pain and has one of these studies, any abnormality that shows up may have nothing to do with the pain. There are other scientific articles in this booklet which look further at this issue.
Experts agree that only in 10% to 15% of the cases can a definite cause for back pain be found. In the rest of the cases NO ONE KNOWS for sure. Chiropractors say misalignment is the problem; physical therapists speak of muscle spasm; surgeons talk herniated and degenerated discs. All may be occasionally correct but most of the time we simply don't know.
At this clinic, in recognition of the above facts, we try to operate from things we DO know. We may not know the precise cause of your pain but we can precisely identify your functional ability and tell you if it's normal or abnormal. If abnormal, we help you strive to make it normal. As you improve your function you will likely experience less pain regardless the cause.
The New England Journal of Medicine is probably the most prestigious and widely read peer-reviewed medical journal in the world. They recently published a study relating to medical imaging like MRI scans.