5 minute read
What do you do when your back pain MRI shows nothing?
When your pain does not get better or it keeps coming back, it is natural that people may get a little anxious to see if there is anything medical going on. It may be the old familiar pattern of a good day followed by a bad day, or despite your best endeavours, the pain is gradually getting worse and you don't know why.
It can spoil your mood, your relationships, drains you of energy and pain can even affect your confidence.
MRI – not what it seems
One of the greatest difficulties with MRI scans is that what you see on the scan is typically not the cause of the symptoms. What one sees on the scan is mostly likely what was there before the pain came and will certainly be there long after you are better.
Research as early as the 1980s showed that people without any pain or symptoms will often be walking around with bulging discs, sometimes multiple bulging discs, arthritis of the spine, degenerative disc disease, etc. What we see on the scan is predominantly wear and tear. This means what you see is not necessarily what is causing the pain, but more often than not, an incidental finding. Though it may look awful on the scan, in professional circles, we say, ‘people may look crappie but live happy'. This again is an anecdote that what you see on a scan often relates poorly to someone's medical complaint. So the correct diagnosis has to be taken as part of the overall medical picture of back pain. That picture includes history and an examination by the clinician. In my last blog https://www.livingcentreclinic.com/working-from-home-back-pain/ I touched upon this.
Back Pain & MRI
So what is going on, and why are these scans ordered if they are potentially unreliable.
First thing to say is that scans obviously have their place. They are done for two main reasons, though there are other reasons too. Firstly to exclude medical condition such as a trapped nerve, cord compression, tumour, infection, congenital anomaly etc. The second is to help prepare for surgery, ie to inform the surgeon of what they might expect.
What Your MRI means to your osteopath
As osteopaths working in Wimbledon, we may use an MRI to help the patient understand what is going on when symptoms are not progressing. We use it to support our clinical management and demonstrate that the patient's re-injury rate is greater than the healing-rate. The scan information provides an objective view for the patient to understand the need to modify their lifestyle, just for a while, in order to get better. That is often a hard ask for many, and as one patient put it “it is hard being good just to get better“! Of course, it is hard to do on your own, so a little help from our friendly osteopathic professionals in Wimbledon might make all the difference.
Osteopathy Treats Back Pain Not Your MRI
Osteopathic treatment can help take you 3 steps forward quite quickly, easing pain and symptoms. But if you go back to bad habits, you may take 2 steps backward. Our work as osteopaths is not just to manipulate pain away, but also to help you manage your health after you leave the treatment room. We do this in a way that supports your lifestyle and not order you “flat on your back for 2 weeks“! Our approach includes advising you at the right time, for the proper length of time, the correct amount of rest, exercise, movement, hot/cold therapy, ointments and much more. In other words we help you to discover what you are doing right and what needs to be changed. You are then able to manage the pain for yourself, not just today but for always.
One of the most powerful reasons why osteopaths, doctors, physios and chiropractors order scans is also to assure the patient nothing is wrong. It also serves as an aide-memoire to the patient. Namely, if the patient sees the amount of wear and tear with their own eyes, it can help them think about wanting to be more careful. For many people they may feel shocked to see what is happening to their health under the radar, and how the body is trying hard to keep ‘head above water', to keep them going.
Ideally at our Clinic in Wimbledon we like to save our patients the cost of a scan. At the time of writing (2021), it is north of £300. Clinically we would commission a scan if the patient has been fully compliant in their care and healing has not progressed along expected lines.
Of course a patient may also request a referral, and we are happy to do this. Peace of mind is everything and can be a much needed part of clinical care and patient education.
We all have different needs and different ways of living. Our experienced team will work with you to get the fastest possible healing for you. With over 35 years of experience from the lead osteopath, we share our knowledge and best practice. We have an onsite rehab gym and 1000s of video exercises to send to your smartphone / PC to help you recover.
Get back to what matters to you
Healing is a balance between movement and rest, as well as treatment and advice. We work hard to provide you with everything you need to heal fast and heal independently. Vispi Jamooji
Vispi Jamooji DO PG Cert SPOP
Registered Osteopath (London, 1986)
Specialist Paediatric Osteopath & Cranial Osteopath
Living Centre Clinic
32 Durham Road, Raynes Park, London SW20 0TW
020 8946 2331