Low Back Pain: MRIs and CT Scans Can Be Misleading
James is an active, 50 year old father with three children. He works as a carpenter, primarily focusing on home
building. He loves to play basketball with his children in the driveway at his home. He plays in a basketball league every winter that meets once a week. However, low back pain has been bothering him for the past few months. He does not remember any specific incident when his low back pain began. Just to be sure, he visits his primary care physician to get his back checked out.
His MD decides to have James get an MRI of his lumbar spine (low back area). James receives a phone call from his MDs office to inform him of the findings of the MRI. He has been diagnosed with degenerative disc disease at L5-S1. James has a million questions race through his head…
Can I ever play basketball again? Is this the end of the days of playing ball with my children in the driveway? Is my job going to make my condition worse? Will I need surgery? What does this diagnosis mean?
What is degenerative disc disease (DDD)?
DDD is a loss of intervertebral disc cushioning which usually affects the cervical (neck) and lumbar (low back) spine.
The cause is relatively unknown, and is traditionally associated with normal aging. The most common symptoms can
include pain in the low back which may radiate in the hips, buttocks, or thighs and flexibility loss in the affected portion of the spine. Although the scary term “disease” is associated with the diagnosis, DDD involves normal, age related changes to the spine. It is much like getting wrinkles on your skin!
How common is degenerative disc disease?
DDD is a very common condition. In a recent study by the American Journal of Neuroradiology, they found 37% of 20 year olds, 80% of 50 year olds, and 96% of 80 year olds all have signs of lumbar DDD when analyzed with an MRI or CT scans. The surprising part of this study was that 3110 asymptomatic subjects were analyzed. This means the subjects did not have low back pain. Therefore, DDD is more a part of the normal aging process than a true “disease” and is not always a source of pain even though an MRI or CT scan shows you have this condition.
Those with DDD can often be treated conservatively and will not need surgery. Many patients find physical therapy to be very helpful. A variety of interventions may be utilized including (but not limited to) stabilization exercises for the lumbar spine, manual therapy and spinal manipulation techniques, and improving posture and altering gait to reduce spinal stress.
How do I get physical therapy?
Often times your MD will prescribe physical therapy, and write you a referral for care. However, Minnesota and Wisconsin are both direct access states. This means you do not need a referral from your MD to see a physical therapist.
What about James?
James had heard about physical therapy from his friend who had a rotator cuff repair a while back. He decided to check it out, and gave OSI Physical Therapy a call. Within the week, he was seen for an evaluation. His questions about his diagnosis were answered by the PT which really eased his mind. He began treatment that day which involved some hands on, manual therapy from his physical therapist as well as some exercises to begin working on at home in conjunction with his PT visits. James’s back pain was quickly relieved, and, more importantly, he never had to give up playing basketball, playing with his children, or miss time from work due to his condition.
- An MRI, CT scan, or X-rays may show a scary diagnosis, but do not be afraid!
- Degenerative disc disease is a normal part aging; it is much like getting wrinkles on your skin!
- Physical therapy can be very helpful in reducing low back pain
- You DO NOT need a referral from your MD to be seen by a PT in Minnesota or Wisconsin
- Call your physical therapist, and we can answer your questions
OSI Physical Therapy offers FREE phone consultations to help answer any questions you may have regarding physical therapy.
Call 651-275-4706 to schedule an appointment or phone consultation
Feel free to contact me via email regarding this post, or any other questions you may have about physical therapy at email@example.com.
– Dr. Derek Scheevel, DPT, ATC