Stopping Thought Viruses: When Medical Imaging is Not Our Ally

Once you see it, once your read it, and once your learn it, it can’t be unseen/unread/unlearned. Medical imaging plays an important role in medicine, but there are times where it actually can make things worse or cause providers to chance down wrong paths. We’re also learning a lot about how our brains can help control our feelings of pain and how loading joints actually might make them stronger instead of break them down. Below are five facts to stop thought viruses:

Neck Pain and MRIs

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A recent large scale study looked at people without neck pain. There were 100 people in each group, both male and female from ages 20-70.

  • 87% had disc bulges, and even those in their 20s had 73% (males and 78% (females) disc findings. These percentages went up as age increased.

  • None of these individuals had pain or symptoms. MRIs do not give you answers or solutions to your pain. See a physical therapist first.

Low Back Pain and Imaging: A Rule To Follow

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Is your lower back pain better...In the morning? As the day goes on? In the evening?
If you answered yes to any of these questions, your pain is variable. Do you think your CT-Scan/MRI/x-ray looks worse in the morning and better in the afternoon? Pain is based on your brain's perceived threat of many things, NOT merely what your back looks like when you're lying in a tube.


Chronic Pain and Quality of Life

The 3 M's of Chronic Pain Control

  1. Mindfulness- pain is an output from your brain- mastery over your thinking assists in pain control.

  2. Movement- controlled and gradual exposure to movements decreases threat associated with them.

  3. Modulation- novel hands on techniques can remove the association of pain with movement and activities.


Running and Knee Pain

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Did you know that running is not bad for your knees? It is actually good for them! A study with over 2000 subjects looked at those who ran at any point in their lives. It found those who ran had- less complaints- less wear and tear found on scans.

Running is an activity of daily living like walking, stairs or any other movement. It is healthy to move and load your joints repeatedly.


Knee Pain and X-Rays

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So you have knee pain and got an x-ray - okay. But...
A study showed when both knees were x-rayed, the knee that did not hurt looked similar and sometimes worse on x-ray.

These findings are normal and are the kisses of time. Chances are, your knee looked like that on x-ray before the onset of your pain.


Aure, Olav Frode, et al. “Manual Therapy and Exercise Therapy in Patients With Chronic Low Back Pain: A Randomized, Controlled Trial With 1-Year Follow-Up.” Spine, vol. 28, no. 6, 2003, pp. 525–531.

Bedson, John, and Peter R Croft. “The Discordance between Clinical and Radiographic Knee Osteoarthritis: A Systematic Search and Summary of the Literature.” BMC Musculoskeletal Disorders, vol. 9, 2008, p. 116.

Cassidy, Emma Louise, et al. “Mindfulness, Functioning and Catastrophizing after Multidisciplinary Pain Management for Chronic Low Back Pain.” Pain, vol. 153, no. 3, 2012, pp. 644–650., doi:10.1016/j.pain.2011.11.027.

“Imaging Tests for Lower-Back Pain.” Choosing Wisely – Promoting Conversations between Providers and Patients, Consumer Reports, 2017, www.choosingwisely.org/patient-resources/imaging-tests-for-back-pain/.

Krampla, Wolfgang, et al. “Changes on Magnetic Resonance Tomography in the Knee Joints of Marathon Runners: a 10-Year Longitudinal Study.” Skeletal Radiology, vol. 37, no. 7, 2008, pp. 619–626.

Macedo, Luciana G, et al. “Graded Activity and Graded Exposure for Persistent Nonspecific Low Back Pain: a Systematic Review.” Physical Therapy, vol. 90, no. 6, 2010, pp. 860–79.

Nakashima, Hiroaki, et al. “Cervical Disc Protrusion Correlates With the Severity of Cervical Disc Degeneration: A Cross-Sectional Study of 1211 Relatively Healthy Volunteers.” Spine, vol. 40, no. 13, 2015, pp. E774–E779.