There is no doubt that the advances in imaging technology has been a great benefit for healthcare. Being able to look inside the body and see what is happening is truly amazing and a time traveller from a recently as a hundred years ago would look on it as close to witchcraft.
But what does imagery tell us really?
When we look at a photograph taken at a wedding, We see exactly what we expect to see at such an important event, and indeed we draw conclusions based on our observations. But lets talk about what the picture doesn’t tell us. Did the Bride and Groom have an argument before the picture was taken? Are the groom’s parents going through an acrimonious divorce and have agreed to put their differences behind them for today? Is the little boy dressed up to the nines dreading tomorrow because he gets bullied in school? Perhaps the handsome man on the left has leukemia and knows he has only a little time to live.
Limitations of MRI
The point is, on the surface a picture can give a very simple impression of a complex situation. Similarly when MRI is using to assess a musculoskeletal problem, it can be very misleading. An MRI shows structures in a moment of time, it does not prove a cause but suggests a correlation. When MRI reports things like degeneration, it doesn’t say that this is the cause of a painful condition because there is no way of knowing what has caused this condition. Research has shown that the ‘problems’ that show up on imaging are not problems at all, but a normal part of an aging process, similarly to skin changes and hair colour changing. As a diagnostic tool for musculoskeletal conditions MRI finding must be interpreted with a great deal of caution. And carelessly stating that a person in pain has a degenerated disk and implying that this is their problem, can lead to inappropriate treatments as well as prolonged pain and comorbidities such as obesity, diabetes and depression.
Positives of MRI
There is no doubt that scanning technology has been great for medicine, early detection of tumours which was nearly impossible prior to MRI has saved countless lives. And fMRI has advanced the study and understanding of chronic pain, and for this we should be grateful. But if you have a pain that isn’t getting better it’s best used to eliminate sinister and dangerous medical conditions. But after these have been eliminated, trust your Physical Therapist who will through a customised rehabilitation programme get you back to full health.
Keep away from Dr Google
Have you been given a scary report of an MRI scan recently? Before you talk to Dr Google, talk to a professional. You will received the best evidence-based advice.
