A large number of individuals undergo advanced imaging in the hope of understanding why they are experiencing pain. But more often than not the results of such imaging will find an ‘abnormality’ or ‘pathology’ which is not necessarily related to or causing their pain. Rather, these findings are incidental and cause more harm than good.
In order to understand why these imaging findings are not the end of the world, it is first important to know the prevalence of imaging findings of degenerative disease in asymptomatic populations.
What does the research say?
A recent systematic review performed by Brinjikji et al. (2015) investigated the imaging features of spinal degeneration in asymptomatic individuals. They discovered that imaging findings of degenerative spine disease have a high prevalence among asymptomatic individuals. All imaging findings examined in this review had an increasing prevalence with increasing age, and some findings (disc degeneration and signal loss) were present in nearly 90% of individuals 60 years of age or older.
This study also found that imaging findings of degenerative changes such as disc degeneration, disc signal loss, disc height loss, disc protrusion, and facet arthropathy are generally part of the normal aging process rather than a result of injury or pathology requiring intervention such as surgery.
They also found that more than 50% of asymptomatic individuals 30–39 years of age have disc degeneration, height loss, or bulging which suggests that even in young adults, degenerative changes may be incidental and not necessarily related to presenting symptoms. So it can be justifiably argued that degenerative spine findings are often incidentally seen and should be considered as normal age-related changes rather than pathologic processes.
So why does my back hurt?
Often these degenerative findings have been present for years before they have been discovered – so why would someone all of a sudden be experiencing pain related to these longstanding issues? What imaging cannot show is joint stiffness/hypermobility or muscle strength and motor control deficits, which are often correlated with lower back pain.
Pain is a complex physiological phenomenon and is not always determined by tissue damage. How you experience pain and to what level is an subconscious decision by the brain aimed to protect us from future harm. We all experience and deal with pain differently because of patterns in the brain and nervous systems. A huge range of factors effect pain type, intensity and duration – for example stress, anxiety, past experiences, sleep and health literacy just to name a few.
If you are experiencing pain and are worried about your imaging findings, whether it be back, shoulder neck or any other body part, a Physiotherapist or Exercise Physiologist can help you understand your pain and develop a plan to get you back on track. Book in to see a Physiotherapist or Exercise Scientist at to Back in Motion Aspendale Gardens.