So you've hurt your low back.... Maybe you felt a pop and now have difficulty standing up straight. Maybe you have some radiation going into the glute or hamstring. OH NO! Sounds like a disc herniation! Should you run to the doctor to get an MRI? Most likely not.... and here's why!
What Will an MRI Tell You?
An MRI for the lower back might tell you something or nothing at all. An MRI is often prescribed to accurately identify disc, nerve, or bonerelated injuries in the lower back. The problem with an MRI and most imaging modalities is that they will often tell an untrue story. What I mean is that they will almost always show SOMETHING. Now is that "something" related to your injury? Maybe. Maybe not. Or the image might show NOTHING and you will be told you are just fine, but obviously you are in pain and something is going on. So there can be many false positives and false negatives when it comes to an MRI for low back pain.
How Does an MRI Lie?!
Many people WITHOUT any low back pain have disc herniations on an MRI. This is why you cannot fully trust what the MRI says! So if you experience a low back injury, you receive an MRI, and a disc herniation is shown. How do you know it wasn't there before the injury? Will your symptoms be blamed on something that was already there? This happens all the time! See below a chart from an article that displays quite clearly the number of individuals that have asymptomatic findings of disc herniation! So how many people have a disc herniation and no pain? You can see that 40% of individuals aged 30 and up have a disc bulge on MRI yet no pain. 50% of individuals aged 40 and up have a disc bulge on MRI and no pain either! This means not all disc herniations cause pain, and is crucial to understand these findings can at times be normal. If this is not understood by you or your provider then your recovery plan can take a wrong turn!
When is an MRI Hurtful?
MRI's can be hurtful in situations where you have just hurt your back and you are immediately told to get one without any indication (indications discussed in the paragraph below). What can happen is as soon as you get this MRI, most likely it will say you have a disc herniation just as it will MOST PEOPLE based on the chart you see above. Remember, disc herniation on an MRI can be normal. However, if this is found then most of the time you will immediately be prescribed an injection or referred to an orthopedist for a surgical consult. This is going from 0-100 and is the reason for so many failed procedures and for the extent of disability that low back pain has on society. This is the WRONG way to go about getting on the right path for low back recovery. The first step should always be a proper assessment followed by a proper rehab program which I take all of my online clients through.
When is an MRI Helpful?
An MRI is helpful if there are any red flags discovered during an assessment or history taking that might indicate the necessity for further investigation. Some individuals may experience neurological symptoms like weakness or numbness in the foot from a lumbar disc herniation but as long as they are not progressing to a point of concern an MRI may still not be indicated. You may have heard the term "drop foot" which is a severe neurological deficit where the muscles are mostly not working in the calf due to the impact on the nerves that go to them. This may indicate a severe obstruction on the nerve which could be coming from a disc and would warrant an MRI. An MRI may also be helpful if you have already pursued a proper rehab program for 4-6 weeks and no progress has been achieved. The lack of response to conservative care may indicate imaging could be necessary, but also this is tricky because if you are receiving poor rehab or the wrong care then it may just be ineffective approaches! I often get asked by my new online clients if they should get an MRI "just to know" and I always say that if an MRI is needed, I will tell my online clients. If it is not needed, I will tell them as well. Having someone that understands your situation and is an expert in this area is crucial to determining the right avenue for you to achieve your goals and find relief as quickly as possible.
Why You DON'T Need an MRI to "See the Problem".
Many people think you need an MRI to "know for sure" or "see the problem". Well as discussed above we have established that many people have disc herniations and no pain, therefore these findings may be meaningless. If you receive a proper assessment from an expert in the low back world, we will know if you have a painful disc herniation or not based on your assessment! I do not need an MRI to tell me that! A classic example of the kind of online client that comes to me follows: "I was deadlifting and felt a pop. Now I'm very stiff in the mornings, putting on my socks and shoes is tough. It's hard to sit for long periods and difficult to stand up straight. I sometimes get some symptoms radiating into the glute as well." So based on this description I can tell you right now they have a disc herniation. Telling them to go get an MRI will only waste their time, money, and potentially scare them! They may be told some horrible things and be scared into invasive procedures! This is not helpful and could cost them way more than they would gain. This is why a proper assessment and proper guidance are so valuable!
How Can You Protect Yourself From Getting A Disc Herniation?
With all this being said, many people are concerned about injuring or re-injuring their low back due to the impact it can have on your life. Well, I understand how serious this is to you and so I wanted to provide a FREE WEBINAR for you to learn my top tips for preventing and recovering from low back, disc herniation, or sciatica-related issues. The more you know, the more in control you will become. I want YOU to be in control of your low back so you can understand how to fix it yourself and manage it properly for the rest of your life without depending on any providers! I love teaching people this stuff!
Still Needing Help?
You are not alone. Many people struggle to find the right help for low back issues. If you found this article helpful, and are still needing that plan you've been looking for with the right guidance to work through it as a team then it is time to take this seriously. If you are ready to get better, and ready for a better plan than you have right now then I would be honored to team up and walk you through this recovery process to make it clear, simple, and easy! Ya disc herniations are not fun, but you don't have to make recovering so difficult. Let me help you! Click the link below to apply for my 1:1 coaching program so we can meet and learn how to effectively resolve this as a team! I look forward to meeting you!
Thanks for reading! -Dr. Grant Elliott