Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome? | Oregon Spine & Physical Therapy

Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome?

Posted on July 8, 2016

Last week I wrote a blog about a new research article about the shoulder and MRI. It helps us better understand the role of an MRI when trying to figure out the best plan to deal with a painful or injured body part. The old belief that an MRI is the “gold standard” is rapidly dying when it comes to understanding what to do with muscle and joint pain. Well today I am writing about another research article that just came out in a very reputable journal called “Spine”. So here is the gist of the study. 202 patients with back pain received an MRI.

The OBJECTIVE: The objective was two fold. First was to see if the severity of the findings on an MRI could predict severity of pain. The second purpose was to see if the MRI could predict who would respond well to back surgery. All patients in the study had back surgery after the MRI.

CONCLUSION: The MRI was a very poor predictor of pain severity or determining who would do well with surgery. Here is the concluding quote from the authors: “The MRI severity of lumbar spinal stenosis has no clear clinical correlation and should therefore not be overemphasized in clinical decision making.” Ok so what is the take home message with this? An MRI can’t predict what treatment is best. Nor can the MRI predict your pain levels. It is entirely possible to have an MRI that looks awful and to have much less pain than someone with mild findings on the MRI. So all of you who have had an MRI that concerns you and sounds scary, take a deep breath and don’t dwell on it. It is entirely possible to respond well to other options such as physical therapy. At Oregon Spine and Physical Therapy we are highly trained in a method of treatment called Mechanical Diagnosis and Treatment (MDT). This is non traditional PT. We can best determine who may benefit from an MRI and who can get better with PT. Again this is continuing evidence that supports the adage of, “PT: The Smart First”.

http://www.ncbi.nlm.nih.gov/pubmed/26352747