Magnetic resonance imaging (MRI) is an extremely useful tool that is used to assist clinical diagnosis of spinal pain and provide guidance on what medical or surgical treatment is required. MRIs are sensitive to detecting any changes within the spine and highlight any discrepancies such as degenerative changes including disc degeneration, disc signal loss, disc height loss, disc protrusion, disc space narrowing and facet joint arthropathy. However these findings can be evident as part of the normal ageing process and do not always relate to the pain or symptoms that an individual may be experiencing.
A systematic review published in the American Journal of Neuroradiology in 2014 found that degenerative changes in the spine, are present in high proportions of individuals that are not experiencing pain.
Of the 3110 symptom free individuals that took part aged 20-80 years old, degenerative changes were found in some subjects in all age groups. Degenerative changes were more prevalent as age increased and were considered normal features of the ageing process, some findings were present in nearly 90% of individuals 60 years of age or older.
The key thing to remember here is that all these people were symptom free, WITH NO PAIN! Therefore, if you have been diagnosed with a disc problem, you may be able to manage this very well with expert assesment and a tailored treatment program.We know that pain is actually a very poor indicator of pathology and symptoms can also be assessed very well through taking a detailed history of the individual’s condition and carrying out a clinical assessment which will highlight issues that would not be visualised on an MRI including joint stiffness, posture, myofascial pain, length/ strength difference and core stability weakness. All of which can cause pain, and can be treated successfully with physiotherapy!