Pluck any person off the street. Here’s what the combo of MRI results and pain symptoms might look like for any part of the body where degenerative changes typically occur.
Most people would expect the matching scenarios—top left and bottom right. But what about the other (common) cases of mismatched findings? Findings on MRI with no pain? Or a clean MRI with severe, debilitating pain?
What’s up with that?
The picture does not equal the presentation.
For me, in clinical practice, imaging can be helpful as a few extra data points. However, I recommend MRI imaging only when a patient hasn’t seen improvement with physical therapy, function with daily activities is worsening, and/or they are considering surgical intervention. Also, in the very rare case that a more malicious disease process is suspected 🚩
You do NOT need to get an MRI before seeing a physical therapist. If fact, I discourage doing so before trying a course of PT.
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