Low back pain is one the most common causes of pain and disability across the globe, affecting more than 80% of all people at some point in their lifetime. Since this is such a prevalent issue, we have invested millions and millions of dollars into research to understand low back pain and what could possibly cause this issue in so many people. Here's what we know.
Low back pain can be categorized into 3 types:Non-specific low back pain accounts for 90-95% of all low back pain cases. Radicular low back pain accounts for 5-10%, and specific low back pain accounts for less than 1%. I promise this will come back into play. Next, let's talk about MRI's.
Logic would say, if you are having an issue with your body knowing exactly what's going on underneath the surface would help us identify the problem and ultimately allow us to fix it. And this is true for many parts of the body. For example - if you hurt your knee, you get an MRI that says you tore your ACL, you fix the ACL and the issue goes away (extreme example I know, but gets the job done!). Unfortunately, this is not how it works for the low back.
So while MRIs are still excellent at detecting anatomical abnormalities (arthritis, degenerative disc disease, herniated discs, etc.) in the low back, the research tells us these anatomical abnormalities might not be the actual cause of your low back pain. Let me explain. There are multiple research studies that have looked at MRI findings in the low back and compared pain-free individuals to those with different types of low back pain. The results are astonishing. The individuals without any back pain at all show the same anatomical abnormalities on MRI as the individuals with back pain. Get this, 37% of pain-free 20 year-olds will show disc degeneration on MRI. No pain, no problems, but MRI findings. And that percentage goes up by decade of life, with a whopping 96% of pain-free 80 year-olds showing this same result. So how can we know for certain that your MRI finding it what's causing your issue? YOU CAN'T!
But there's no harm in getting one just to be safe, right? Wrong! Pre-mature low back imaging has been shown to increase disability, increase time to recovery, and increase overall medical costs. How is that possible? When people are told that the MRI shows something wrong with them, they are programmed to believe that they are supposed to be in pain until that finding goes away (which we now know, might not ever happen). Essentially they are unable to recover, because they believe that they are supposed to be in pain. Crazy, right?!
As we talked about earlier, low back pain is categorized as either non-specific, radicular, or specific. The only time a MRI is warranted is if a specific low back diagnosis is suspected. These specific diagnoses are medical emergencies and should be treated as such.
So how do you know if your low back pain is a specific issue? Like I said before, specific low back pain accounts for less than 1% of all cases, so don't stress. But to be safe, be on the lookout for these "weird" symptoms:
Check out future blog posts on how to effectively treat your low back pain!