Does Your Lumbar Spine MRI Reallyyyy Matter That Much?

I don’t know who needs to hear this, but your MRI does not dictate your progress and your spine is NOT made of glass.

Far too many times, I’ll have a patient come in for an evaluation and ramble off all the things “wrong” with their back told to them by their MD. They’ll tell me how the orthopedist told them they have a bulging disc and they should stop all recreational activities. Sometimes I’ll even hear that the patient had been told to stop squatting and deadlifting altogether!

The issue with this is it creates a fragile mindset. The patient begins to think any activity at all will further injure their back and that they need to live in a bubble. They think that life as they know it is over and they’ll never get back to the activities that they love doing.

Let me ask you, how did you sit into your kitchen chair this morning for breakfast? You squatted. How about picking up that grocery bag from the floor? Yup, that’s a deadlift. You see where I’m going with this? Sure, you might not be barbell squatting day one, BUT there are many different variations of a squat that can be modified for the time being.

Physical therapy happens on a spectrum. You have the simplest variation of a squat all the way down to the most complex variation. We need to find where you are on that exercise spectrum and start there.

There was a study done in 2014 looking at spinal degeneration in asymptomatic (no symptoms) patients. Nerd alert, I know! Stick with me. The study looked at the MRIs of 3110 people ranging from 20 to 80 years old and the prevalence of disc degeneration, disc bulges, and disc protrusions. The higher the age, the greater percentage of disc degeneration, bulges, and protrusions, BUT all these patients had zero symptoms.

So, what does that tell us? It tells us that the MRI is just a piece of the puzzle. It gives us an idea of what is going on. As a physical therapist, the communication with our patients plays a much larger role. What symptoms are you feeling? What movements make the back feel worse? What movements make the back feel better? Where are the symptoms? These are just a few of the many questions we’ll ask each session to monitor progress and make the appropriate modifications/progressions.

Disc degeneration is a normal part of the aging process. That’s going to happen, but that doesn’t mean there needs to be symptoms associated with it. It’s just a matter of working on any mobility and/or strength deficits so that you are optimizing your movements throughout the day, moving as efficiently as possible, and placing less stress on the spine.

As physical therapists, we treat your symptoms, NOT your diagnosis. Sure, we may need to modify certain activities for the time being, but our job is to get you back to those activities pain free. So, the next time you’re in pain, save yourself time and go straight to a physical therapist. We’re the movement specialists. Let’s get you moving pain free!