“Should I get an MRI?”
I frequently get this question. And here are my thoughts as a physical therapist.
- “Well let me ask you a question, what would you do with the information you get from the MRI?”
- “Are you interested in having surgery? “
Most of my patients will say:
- “Well, no I don’t want surgery, but I want to know what is going on in there?”
As we continue in to our conversation, my patients will then tell me:
- “My friend who has had the ‘same pain’ had an MRI and she needed surgery.”
- “My friend (who works in the health field) said I should have one.”
- “My spouse just wants this better and wants me to go have an MRI to see if I can just have surgery and get this fixed and over with.”
I then review with my patient what the diagram indicates in this post, that many times an MRI will reveal degenerative changes, knee meniscus tears, rotator cuff tears, and neck/back disc bulges, to name a few, and in most cases these people are completely asymptomatic.
There have been numerous studies to support that an MRI will see various abnormalities in asymptomatic people---people that are not having pain in the area where the MRI found the abnormality.
For example, in this study:
- If you take 1,211 people, between the ages of 20-70 years old, all not suffering with neck pain and give them an MRI.
- 87% had Disk(s) Bulging
- They were all ASYMPTOMATIC—meaning they were not complaining of neck pain.
- 1054 People had DISK BULGING, did not know it, and did not feel pain!
So, if at the onset of a musculoskeletal issue you are considering immediately having an MRI, please do know that the issues they see on MRI may have been there for a very long time, and were not causing you any pain whatsoever. What may be the real issue now, is that there are other factors in play, such as inflammation, muscle tightness, improper form/positioning, and loss of strength, that has placed more stress on the ‘positive” issue found on MRI. We can work on those factors. A pill will not fix those factors. Surgery is not necessary when those factors are corrected. In addition, if you see what is on an MRI, your mindset will change. You will think you are broken, something needs to be ‘fixed’, you will change how you move and compensate, and then you will think that only a surgeon has the ability to help you at this point. You give up on helping yourself. You become at the mercy of the medical system.
All the while, you had that issue for years, did not feel a thing, or were quite functional with maybe a twinge or two here and there. (And by the way…these twinges could be fixed as well with a some stretching, strengthening and positioning/form education, if you choose to see a physical therapist to look in to them first before they become a full-blown injury).
In closing, ask yourself: Should you have an MRI? What are you going to do with that information? Do you want surgery?
If the answer is “No, I don’t want surgery”, then when you are having pain, pursue conservative therapeutic care first, put the work in to helping yourself. We all need to put in the work, be patient, and put the time in to rehabilitation our bodies, instead of looking for the quick solutions in the form of medications, injections, or surgery.
Thank you for your time!