Do you need an MRI for your pain: What you need to know
9 min Read
Wondering if you need an MRI for your pain? You’re not alone, it’s one of the most common questions I get. The truth is, imaging doesn’t always explain what you feel. Pain is complex, and there’s often much more going on than what shows up on a scan. As an Athletic Trainer, I focus on movement-based care that helps you understand why your body is protecting itself and how to create lasting relief. without relying solely on what the picture says
I treat People, not pictures
It is surprising to me how many people want to delay treatment because they don’t yet have an MRI.
Here is the scenario:
A person sets up a discovery call with me to see if I can help them….
This is actually usually the first question they ask me.
“Can you help ME?”
As if they are hopeless and broken.
After discussing their current situation many times they will say
“This sound great but I want to get my MRI first so I know what's wrong”
Truth, an MRI is JUST a picture
It doesn’t tell the whole story! There are many factors that influence a person's pain; movement quality, nervous system sensitivity, previous injuries, even stress and sleep. Imaging can’t capture those things.
There are a lot of things we can do to help reduce pain and improve how you move without waiting on an MRI scan.
I’m not saying don’t get the MRI. I’m saying don’t put off getting better and while waiting for a piece of paper to say you should start!
What usually happens after the MRI:
MRI finds something:
a tear in a meniscus in the knee
a rotator cuff in the shoulder
a bulging disc in their low back
arthritis in their hip (or any joint for that matter).
Now they have a label, and they are very connected to their label.
“My back is Bad, I have a bulging disc”
“My knee is Bad, I have a torn Meniscus”
“My shoulder is Bad, I have a torn rotator cuff”
They are now “broken”
Various studies have show otherwise. Anywhere from 25-40% of shoulder MRI’s show asymptomatic rotator cuff tears.
33% of baseball pitchers have asymptomatic rotator cuff tears.
50% of people over the age of 60 have asymptomatic rotator cuff tears
So there is more going on than just what is in the picture.
A study of Low Back MRI’s showed that 52% of bulging discs were asymptomatic! So this shows that just because it’s bulging doesn’t mean you have pain. Also is it bulging and pushing on a nerve or just kinda squishing out a bit. As we age these numbers go up 20% of young adults can have asymptomatic bulging discs, that number increases to 75% of those aged 70 or older!
2. MRI shows nothing.
This one frustrates people even more,
“If nothing’s wrong, why do I still have pain?”
Sometimes I almost prefer this because now we can get started on listening to the body, see what it is protecting and start getting that person to feel better! (I do this by using an Assessment tool called the LTAP, designed by Certified Athletic Trainer Anna Hartman @MovementRev) I also discuss this in my Blog about Hierarchy of Protection.
LIstening to the Body not the Paper
Again I want to treat the person in front of me. I want to listen to what their body is telling us and addressing that, not what the paper says.
The LTAP helps me identify whether your body is protecting an organ (the viscera) or the nervous system. When those systems feel threatened, they create tightness, it’s ike a protective hug.
Once the area is identified, I use modalities such as soft tissue, cupping, quing specific movements to help your body feel safe again.
I know it might sound a little “woo-woo,” but it’s rooted in physiology, your musculoskeletal system exists first to protect you, and second to move you.
When you NEED and MRI
Again, I’m not saying getting imaging is wrong….there are times that it is very important such as:
After acute injury with severe swelling or loss of strength
Numbness/tingling that doesn’t improve
Unexplained night pain or rapid weight loss
Post-surgical progress checks
These are all red flags that can warrant and MRI and collaboration with a Medical Doctor
Client Story
Just a couple weeks ago I had a woman come in to see me. She had foot surgery over 7 years ago for a torn posterior tibialis tendon. (This is the tendon that creates your arch in your foot.)
She did her post surgical rehab and initially felt a bit better, but for the better part of the last 6 years has had excruciating pain that continued to get worse. She tried several more bouts with PT and had MRI’s which showed a successful surgery from the Dr’s point of view from the MRI. But still she was in pain
She walked in with a very noticeable limp favoring that foot. She also complained now of knee pain (probably due to her altered gait). During our 1st session we went over her complete history of this injury and all of her other past injuries because they can contribute to her current pain as well.
Then we went through a movement assessment of all her joints to see how everything else moved.
Then I went through the Level 1 LTAP. We did some breathing exercises to down regulate her nervous system. People who are in constant pain tend to be in fight or flight constantly so there nervous system is on high alert. In order to get better results this need to be addressed.
Finally, I gave her 3 very basic and easy movements for her to work on at home.
During this session she rated her pain usually around a 6 or 7 out of 10, so pretty uncomfortable.
She came in again this week and reported her pain down to a 3 out of 10, so significantly better! She still had a bit of a limp but she was so hopeful that her pain had decreased and that there was a future for her that could be pain free!
At this 2nd session I did the LTAP again, and again the nervous system came up as a protection pattern. So this time I had her walk and count by 3s. Not only did she not complain about her foot but she walked dramatically easier and smoother, her limp was barely detectable!
She has been so hypervigilant in protecting her foot since surgery she created even more tension causing more pain. This was something that had not been addressed previously!
She literally walked out feeling like she could go hiking again, one of her main goals! And with no limp!
I can’t wait to see her again next week to see how she is doing!
You are NOT your MRI
This is not the first time I have seen people get results like this! Usually within the first 1-3 sessions there is a change in peoples pain…and that is the most important piece. Once your pain has decreased then we can work on increasing mobility and strength and all the things to keep you moving and feeling better!
This is exactly what we do during one of my Orthopedic session. To learn more click HERE
If you can relate to this above, schedule a discovery call now and we can discuss how I can help you! Or you can submit a form HERE and I will contact you at my earliest convenience
Next on your reading list
2. What is Visceral Manipulation
3. Injury Recovery isn’t just Rest. How to Heal and get back to performance