Why imaging of your spine does not tell the story

  • July 10, 2017

Many of the patients who come to see me with spine (neck or back) problems in particular already had imaging. Most if not all come in saying “I have arthritis” or “I have degenerative or bulging/herniated discs”. Yes, well so do 50-70% of people over age 40 who DO NOT have pain. These changes are called wrinkles on the inside and they are NORMAL.

Herein rests the problem with imaging the body for aches and pains (it does not tell the whole story). With imaging, what you get is a one time static picture of your body. BUT what you must know is most changes in the body do not happen instantaneously (Traumatic events aside). That “abnormality” someone sees on imaging has been there for months or years when you did not have aches or pains. So why then do you now suffer with pain? A day’s worth of writing would not be enough to answer this in full, so I 

will keep this brief.

Basically, somewhere along the way a signal (that you may or may not have been aware of at the time) reached your brain with an ouch message. You may have picked something up awkwardly, strained reaching for something, slept funny, etc. So, from that initial ouch message, your brain created a pain response that you became conscious of. Now normally this message is protective to keep us from doing something stupid in the short-term. It gives our brain a chance to further assess the situation and determine how important that ouch message really was. (By the way- during this time there was no change in what an image of your spine looks like). For some reason, this ouch message does not get turned off the way it should. SO, that pain message lasts and spreads (a complex process so just run with it).

Now weeks or months later you are still suffering, even though normal muscle, tissue, joint, and bone healing time has well passed. Life is becoming more consumed with this pain such that you finally seek help. The doctor takes a picture of your spine (or body part) before they even talk with you or touch you. Then BANG- THERE IT IS- the root of your problem. See that tiny “bulge” there- that is why you hurt. Oh, plus you have this degeneration of your spine (or pick the body part) there- that is the worst. I forgot to preface this with the fact the patient is 55 years old so these findings are NORMAL.

So now that doctor just added more fear and anxiety to the person already worried about their problem impacting their life. Cue more pain chemicals to further drive the persistence of pain.

Back to imaging not telling the whole story. So now we know age changes on the inside are normal. And we know it is possible to have pain outside of normal tissue, muscle, etc damage or injury. So what is left? To turn you back into the person with WHATEVER may appear on an image but WITHOUT the pain. This is the #1 goal I work with patients on.

No, it is not necessary to see those images because they do not answer the question of how best to treat you or help you feel better. The real story comes from you, the patient (not some image). All I care about it how you move, function, your goals and more. Learning about you, helps someone like me create a plan to help you achieve your goals. Addressing strength, flexibility, coordination, and yes even sometimes psychology or pain sciences are part of helping you feel better.

Are you tired of living with pain? Do you need more proof that those pictures of your spine (or otherwise) are not the true source of your problem? Curious how physical therapy may be able to help your spine problem? If so, learn more Here for back or Here for neck. Or Click HERE to read about the most commonly asked questions related to physical therapy

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Zang Physical Therapy ~ 836 Market St, Lemoyne PA 17043 ~ 717-440-6197 ~ andrew@zangpt.com ~