MRIs are incredible tools for evaluating the inside of the body. They give as better detailed pictures of the bones and the body's tissues.
A common question people have is if an MRI is needed to evaluate their injury. They are familiar with MRI's quality pictures for evaluating the inside of the body, but what does the MRI show? How is it used in their treatment?
MRIs are a 3D picture of the body. They show bones and soft tissue: the muscles, tendons, organs, and other stuff that is inside our bodies. MRIs of the low back show the bones, spinal cord, potential arthritis, disc herniations, disc bulges, or anything compressing a nerve. They are a tool to help us confirm or rule out a condition.
An MRI won't show us normal muscle, tendon, and ligament sprains. By not showing a lumbar disc problem it suggests that the injury is more of a sprain in muscles, tendons, ligaments, or joints.
Often patients think that we need a MRI to determine an injury. In the clinic, the physical exam usually tells us where the injury is located and which tissue was injured. Your chiropractor or physical therapist will go through a series of physical tests. Each test is designed to cause pain; where the pain is and what it does tells us information about the injury.
For example, if you have severe low back pain that feels like a large oval centered on your beltline that is worse when getting out of a chair, sitting/standing too long, going up stairs, and hurts with certain tests, it indicates a low back sprain. If the pain is decreased with other positions and pain isn't increased with other tests, it gives us greater confidence that it is a lumbar sprain
Other times you can come into the office with low back pain radiating to your big toe, weakness in the toe, changing sensations down the leg, and I can reproduce the pain with several tests. That suggests you have a lumbar disc herniation.
An MRI would confirm the diagnosis, but it wouldn't change the treatment plan. If it looks like a lumbar disc, we are going to treat for a lumbar disc. We should see it continue acting like a disc injury and improve like a disc injury should. If you don't get better, symptoms worsen, or it starts acting like something else, then an MRI would influence the treatment and will be utilized.
I have a saying that if it acts like a duck, walks like a duck, your history sounds like a duck history, and orthopedics suggest it is a duck... then treat it like a duck and it should get better like a duck.
For more information on Low Back and Sciatica click here.
Disc herniations information can be found on the Lumbar Disc Decompression page.