“Do you think I need to get a scan?” is a question physiotherapists and most other health professionals are asked on a daily basis.
The belief behind the question is obviously that a scan will reveal what is causing their issues and that it will lead to a faster fix.
But is this the case? The answer is often no.
The belief behind the question is obviously that a scan will reveal what is causing their issues and that it will lead to a faster fix.
But is this the case? The answer is often no.
The stats above give a good snapshot of how imaging results aren't always relevant to the cause of your problem.
Take a look at the below graph. This shows MRI findings, divided between those with and without knee pain. The prevalence of each type of “damage” within the knee is almost identical in those with and without pain. The same type of findings have been proven repeatedly within the spine (back, neck), shoulders and many other areas.
Take a look at the below graph. This shows MRI findings, divided between those with and without knee pain. The prevalence of each type of “damage” within the knee is almost identical in those with and without pain. The same type of findings have been proven repeatedly within the spine (back, neck), shoulders and many other areas.
Likewise, if you look at this graph, it demonstrates in the spine how as we age we get increasing damage/degeneration. It also shows how this is present from an early age. However, all of these results come from pain free individuals. What this tells us again, is that degeneration is not the significant reason for pain and disability.
Of course there are times where imaging is necessary.
Some acute injuries, or injuries that present with “red flags”- signs of something more serious that require further investigation- will need or benefit from further investigation. Your trained health professional will be able to guide you on when this is the case and be able to interpret the results and relate them with your symptoms to advise you what findings are relevant.
There is even evidence that links having scans done to worse outcomes. How could this be?
Sometimes what seems like significant, bad findings on scans may have been there for much longer than you have had an issue. They are often totally irrelevant to your current complaint. Uncovering these findings may cause fear of exercise or other things which in many cases may be exactly what you need to actually get better!
So what is causing the pain?
In these situations, the pain is related to the inflammation, not the degenerative structural changes shown on the scan.
If your body is moving well, loading through the joints and tissues will be minimised and inflammation will be reduced. If not, it will build up and create pain.
If you are not exercising at all, your body will lose mobility and strength and this will agin increase the load on the body.
A thorough assessment will assist in identifying your movement dysfunctions and correcting these will unload the body to improve your symptoms.
However, if you have surgery to “fix” degenerative changes in a back, knee or shoulder your movement patters wont necessarily change, in fact they can become worse throughout the recovery phase from surgery, and so neither will your issue in the long term and possibly even in the short term.
Some acute injuries, or injuries that present with “red flags”- signs of something more serious that require further investigation- will need or benefit from further investigation. Your trained health professional will be able to guide you on when this is the case and be able to interpret the results and relate them with your symptoms to advise you what findings are relevant.
There is even evidence that links having scans done to worse outcomes. How could this be?
Sometimes what seems like significant, bad findings on scans may have been there for much longer than you have had an issue. They are often totally irrelevant to your current complaint. Uncovering these findings may cause fear of exercise or other things which in many cases may be exactly what you need to actually get better!
So what is causing the pain?
In these situations, the pain is related to the inflammation, not the degenerative structural changes shown on the scan.
If your body is moving well, loading through the joints and tissues will be minimised and inflammation will be reduced. If not, it will build up and create pain.
If you are not exercising at all, your body will lose mobility and strength and this will agin increase the load on the body.
A thorough assessment will assist in identifying your movement dysfunctions and correcting these will unload the body to improve your symptoms.
However, if you have surgery to “fix” degenerative changes in a back, knee or shoulder your movement patters wont necessarily change, in fact they can become worse throughout the recovery phase from surgery, and so neither will your issue in the long term and possibly even in the short term.
Remember- that all seeing “scan” you have had doesn't hold all the answers and in fact may be what is holding you back from returning to your best!
Scans give us a snapshot of that part of the body. There are various scans available (Xray, Ultrasound, MRI, CT, etc) that will tell us different information. However, the important thing is to understand what information they show us and interpret it correctly to assist in what you then do.
To put it simply- scans are helpful (although not always essential) when diagnosing specific pathology, that is acute tears, nerve root compression, fractures, etc. However, scans are NOT useful relating to chronic, wear and tear changes- that is joint or cartilage degeneration, disc height loss, disc bulges (unless compressing a nerve), etc. The way the body moves to overload the body is what matters here.
Scans give us a snapshot of that part of the body. There are various scans available (Xray, Ultrasound, MRI, CT, etc) that will tell us different information. However, the important thing is to understand what information they show us and interpret it correctly to assist in what you then do.
To put it simply- scans are helpful (although not always essential) when diagnosing specific pathology, that is acute tears, nerve root compression, fractures, etc. However, scans are NOT useful relating to chronic, wear and tear changes- that is joint or cartilage degeneration, disc height loss, disc bulges (unless compressing a nerve), etc. The way the body moves to overload the body is what matters here.
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