HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter
TREATING THE PATIENT AND NOT JUST THE PICTURE
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SHOULDER A recent study showed that two out of every three patients over the age of 70 have rotator cuff tears and do not have any symptoms. 2 KNEE A study of the knee showed that there was only a 50% correlation
What role does an MRI or X-ray play in a patient’s symptoms and treatment? Imaging results are a slice of the pie in the grand picture of what a patient is feeling. It is a snapshot in time of what is going on in a very specific region, in a static position, but it does not tell the entire story.
between knee pain and arthritis. 3 What do these studies mean?
By Scott Hoffman, PT, DPT, Jenkintown Clinic
Findings in an MRI should not be considered a barrier to your full recovery. These studies show that findings don’t always equal pain, nor functional limitation. Think of these findings like grey hair on the inside of the body, just a natural part of aging! Furthermore, it is common to still have full function despite findings in an imaging scan. The most important question is to discover how a patient’s imaging results fit into the big picture on their road to recovery. If a patient comes to physical therapy with pain and findings in an MRI or X-ray, it should not be considered a limiting factor to achieving their goals. There are cases when the findings in an image need to be addressed by other medical professionals. At Excel Physical Therapy we highly value continuity of care and will work with you and your physician to determine the best treatment for you. What to Look for in a Physical Therapist? When the time is taken to examine all the components of our musculoskeletal and nervous system, good results are likely to follow. An in-depth, 60-minute, one-on-one evaluation will allow your skilled therapist to take a look at the big picture, examine how multiple body parts are functioning, and decipher what role imaging results play in a successful treatment strategy. Excel Physical Therapists are able to spend ample time with patients to uncover the foundational issues, and make adjustments as symptoms change and improve. When you take a step back and see the whole picture, you can find the best solution and relief from your pain. Discussing your imaging results with your physician and working with your physical therapist will help you see the big picture and pursue the best treatment for you.
Bodies were made to bend, twist, move, and reach, and the coordination of our nervous and musculoskeletal system changes with every movement. Our bodies are extremely complex and all the body systems are integrated within each other, making someone’s pain a combination of multiple systems. A skilled therapist working with the referring physician will be able to examine all the components affecting someone’s symptoms and put together a complete plan of care to address a patient’s pain and limitations. We treat patients every day with a variety of painful complaints that are intrusive to their quality of life, sports, and work demands. Patients may experience back pain, shoulder pain, or knee pain, and present an X-Ray, MRI or CT scan with abnormal findings. However, we all age, and aging involves tissue degeneration over the years. Tissue degeneration and the buildup of microscopic injuries are clearly shown on a scan or X-Ray and basically reflect the aging process. In fact, there have been numerous studies conducted to examine how often patients with no painful symptoms have significant MRI Scan findings. SPINE Common results from imaging of the lumbar spine include degenerative disc disease, arthritis, and bulging discs. A study in 2015 found that 52% of thirty- to forty-year-olds without low back pain have lumbar disc degeneration in their imaging results, and 80% of fifty-year-olds without low back pain have lumbar disc degeneration¹. The conclusion: “These findings suggest that many imaging-based degenerative features may be part of normal aging and unassociated with low back pain”. Similar results have been found in other joints as well including the knee and shoulder.
Contact your local physical therapist to learn more and always discuss an MRI or any test results with your physician.
References: Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. doi:10.3174/ajnr.A4173. Milgrom, Schaffler etal.1995. Reilly, Macleod etal.2006. Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC musculoskeletal disorders. 2008;9:116-116. Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol 49, 1099–1107 (2020).
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