MYTH is that herniated discs or other degenerative changes revealed by MRI are major causes of back pain. Many people who learn of these structural changes will assume it is the cause of their pain and start to consider surgery as a solution. However, numerous studies show that many types of structural abnormalities are poor predictors of pain.
In one famous study, MRIs were performed on subjects who did not have back pain.The relation between abnormalities in the lumbar spine and low back pain is controversial. They examined the prevalence of abnormal findings on magnetic resonance imaging (MRI) scans of the lumbar spine in people without back pain. Fifty two percent of the subjects had at least one bulging disc or other MRI abnormality for which surgery is sometimes recommended. Given these findings, the authors stated that: “the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.” In a similar study, MRIs on individuals who had never suffered from low back pain revealed that one third had a substantial spinal abnormality and 20% under the age of 60 had a herniated disc.
In a study Seventy percent of healthy professional and collegiate hockey players had abnormal hip and pelvis MRIs (magnetic resonance imaging), even though they had no symptoms of injury, according to a study presented March 13 “this study shows the limitations of depending too heavily on an MRI. A surgeon may see something in the image, but it isn’t causing a problem.”
In this study, researchers examined forty four volunteers, age 20-68, with no history or symptoms of knee pain. Sixty percent showed abnormalities in at least three of the four regions of the knee, causing the authors to conclude that “meniscal degeneration or tears…are highly prevalent in non symptomatic individuals.”results suggest that osteophytes may be more prevalent in this population than radiographic data suggests due to the limitations of two-dimensional imaging. Meniscal degeneration or tears, a risk factor for knee osteoarthritis, are highly prevalent in non symptomatic individuals with the medial anterior and posterior horns of the meniscus being the most commonly affected regions.
Studies of active baseball pitchers or overhead athletes consistently demonstrate very large percentages (over seventy percent) of torn labrums and rotator cuffs with no pain.
These are all issues for which surgery is sometimes recommended.
This is not to say that herniated discs, torn labrums or other structural abnormalities cannot cause pain. Of course they can, and you would rather have less damage than more. But if a large percentage of pain free people have bulging discs, then how likely is it that a bulging disc is the cause of your back pain? If you look close enough at almost any joint in the body, you will find something wrong with it. Don’t assume that whatever shows up on the MRI is the source of your pain. Pain is multifaceted and complex.