If you’ve had imaging, such as an X-ray or MRI, to investigate your pain, your report may have come back with a list of awful-sounding ‘abnormal’ findings.
It can be tempting to assume that these findings explain your pain. But pain isn’t always that simple.
Many tissue changes that sound concerning on a scan are also commonly found in people without pain. For example:
- 30% and 37% of people in their 20s with no back pain had disc bulges and disc degeneration in their spine, respectively (see the table below for your age group).1
- 96% of 11‒26-year-old athletes with no back pain had spine abnormalities.2
- 57% of 20‒50-year-olds with no hip pain had cartilage defects and/or labral tears.3
- 19‒43% of people aged ≥40 years with no knee pain had osteoarthritis.4
What’s especially interesting is that, in some studies, these so-called ‘abnormal’ findings were more common than having no findings at all.
So, are they really abnormal? Or are many of them just normal age-related changes?
Of course, this does not mean imaging findings are never important. Sometimes they are very relevant, especially after significant trauma or when symptoms suggest something more serious.
However, imaging findings should always be interpreted in context, alongside your symptoms, history and a thorough assessment from a trusted health professional.
Pain can be influenced by many factors, and tissue changes may be only one part of the picture. One common pitfall is becoming fixated on what the scan shows, even when those findings may not need to be ‘fixed’ for you to feel better.
The good news is that tissue changes do not always need to be reversed for pain to improve.
There are often many things you can work on, such as managing training load, gradually building tolerance, improving sleep, reducing stress, and returning to the activities that matter to you.
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References
- Brinjikji et al. (2015) (PMID: 25430861)
- Rajeswaran et al. (2014) (PMID: 24691895)
- Tresch et al. (2017) (PMID: 27981665)
- Culvenor et al. (2019) (PMID: 29886437)
