Similar results have been found in other areas of the body. A study on individuals with pain in one shoulder who volunteered to have both shoulders imaged found just as much “pathology” including rotator cuff tendinopathy, ACJ arthritis, bursitis, labral lesions, and partial rotator cuff tears, in the pain free shoulder as the painful shoulder. The main pathology that demonstrated a significant difference between the painful and non-painful shoulder was a full thickness rotator cuff tear. Another study found similar results in painful and non-painful knees, with both knees having as much “pathology” including osteophytes, cartilage degeneration, and meniscal lesions, on MRI findings.
This is not to say that imaging is not useful, nor that it should never be used. In the presence of serious or sinister signs and symptoms, images will help make fast, accurate diagnoses. However, without serious or sinister signs and symptoms, images can lead to overdiagnosis, unnecessary costs, and increased stress levels. Images are to be utilized to exclude the worst of the worst, but when it comes to everything else they cannot and do not tell us where the pain is coming from. Most musculoskeletal aches and pains do not have one specific cause. Factors such as muscle imbalances, body mechanics, and overuse are all elements to be addressed to decrease pain and improve function. A Physical Therapist will evaluate you as a whole, develop a treatment plan to have a cumulative effect on the tissue, and allow you to live your best life. Contact PTI today to find out how we can effectively diagnose and treat the underlying causes of your lower back pain.