I have ordered a lot of MRIs during my chiropractic career. I have order less as I progressed thru my years of practice. I have found that most people will have some changes on an MRI. The most common finding includes, arthritis, disc bulging and disc hernation.
If your over 40, good chances that you’ll have some changes/finding on an X-Ray of MRI. I can only think of two recent patient that had no finding on their MRI.
Does a finding on an MRI mean it’s the pain generator? No, it does not. As a doctor we should treat the person in front of us and not an image.
If the symptoms warn it or patient fails to progress at all, then advanced imaging might be needed. The most common advanced Image is an MRI. Magnetic Resonance Imaging (MRI) is a non-invasive imaging technology that produces 3d images of the body.
Here a great study that showed most people have finding and asymptomatic
“We performed MRI examinations on 98 asymptomatic people. The scans were read independently by two neuroradiologists who did not know the clinical status of the subjects. To reduce the possibility of bias in interpreting the studies, abnormal MRI scans from 27 people with back pain were mixed randomly with the scans from the asymptomatic people.”
“On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental.”
So, if you have finding on a MRI and are having symptoms. maybe the pain is coming from the finding or maybe it not. The important thing is to treat the person as a whole and not just a finding.
N Engl J Med. 1994 Jul 14;331(2):69-73. Magnetic resonance imaging of the lumbar spine in people without back pain. Jensen MC1, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS.