You have been walking around with chronic pain complaints for quite some time. Back pain, neck pain, shoulder pain, hip pain, knee pain or a combination of pain in multiple places in your body. You try everything but the pain doesn’t go away.
You have already turned yourself upside down at the doctor’s office 10 times and you have opened your entire bag of tricks to get a referral for an X-ray and MRI scan. And yes you finally did it! They are going to take a photo and/or MRI to finally see what is going on with you! You finally get more clarity! Finally you will know what kind of treatment you can do when you finally know what is going on!
But is that so? Is the MRI really going to give you more clarity? What will the MRI tell you? And what can you do with the information that you will get from it?
The result of the X-ray or MRI scan comes in. There can now be 2 results:
Result option 1. There is nothing special to see ma’am/sir, everything looks normal, I can not do anything else for you, your pain is probably between your ears, I can refer you to a psychologist OR; There is nothing special to see ma’am/sir, everything looks normal, I can’t do anything for you, I think you should learn to live with it that the pain is not going to get any less than it is now. You could possibly do exercises at a physio or improve your posture, perhaps that this will give some pain relief and more freedom of movement.
Result option 2. Oh yes ma’am/sir, take a look at the photo, do you see the deviation here? Yes, yes, we suspect that this is the cause of your pain, so we think it is necessary to operate on it.
Well what result would you rather have. Maybe you would prefer to get result #2, purely because then you finally know what’s going on, that you’ve finally found the cause of your pain. And that they give you a solution that may take your pain away! Well, then operate, then we are done with it and we can continue with our lives!
HOLD, WAIT A SECOND!
The MRI scan & X-ray results.
What do these actually say??
You are being told to have a bulging intervertebral disc, disc degeneration (wear), herniated disc, spinal canal stenosis, partial rotator cuff/rotator cuff tear, bursal thickening in your shoulder or hip, osteoarthritis, cartilage defect, meniscal tear, bone deformation, labrum injury or other general deviation.
Okay, you do. But where exactly is the proof of the link between THAT and YOUR PAIN? Well listen I have proof here, you can see that on the MRI scan! No, your MRI scan is only proof that you have this or that “deviation”, no more no less. It is no evidence that this “deviation” is also the cause of the pain. Just ask your doctor, “can you guarantee to me that this “deviation” is actually the cause of my pain or is this just an assumption? I’m curious to know what they will say!
You may also have “abnormalities” in other parts of the body where you are not in pain, who knows, but there’s no MRI being done on that, so you are not aware of that.
Why I keep writing “deviation” with quotes?
Well, simply, because it is not a deviation in my view. It is normal. Deviations are normal. I also have osteoarthritis in my lower back, I have 0% pain.
After all, wear (or degeneration) is a NORMAL & NATURAL process that occurs to a greater or lesser degree in every person’s life. This can lead to pain complaints, although this does not always happen. AND reason is not also directly the cause!
Congratulations, so you are completely normal! No, but without joking. Seriously, it really doesn’t say more than that.
So is surgery immediately the best solution if the answer to the question whether this normal deviation is the cause of your pain is still not certain? For example, a herniated disc, in only about 3 to a maximum of 5% of people with a herniated disc seen on the MRI, surgery is really necessary! Hello only 3 to a maximum of 5%! However, you will not be told whether you fall under that 3-5% or under the other 95-97%!!
This 3-5% is for example when the person also experiences severe paralysis in the legs or loss of control over the urinary bladder as a result of entrapment of the cauda (cauda syndrome) or serious cases where you really can no longer function normally at all.
So when doctors advise you on surgery, it can mean that:
– you belong to that super small group of unlucky ones who happen to REALLY need surgery.
– You are among the 95% -97% of people who do not need surgery because there really is not enough reason to say that the pain is caused by the “abnormality”. And yet they offer you the operation as advice.
But in most cases they will not be able to tell or guarantee which of the 2 groups you fall into, the 3-5% or the 95-97%. In any case, they often advise surgery.
But ok so there is a very high chance that you, without knowing this (because the doctor often does not tell you this), fall underneath the 95-97%. Do you then agree with the doctor’s advice to have surgery? Although there is not enough reason to say that the pain is caused by this “deviation”?
An operation that ALWAYS has a risk factor, even if it is a “routine operation” for the surgeon. Risks such as infection, nerve damage and of course the chance that the operation will not relieve your symptoms. Is it worth that? OR does it make more sense to open up to other options, to investigate further what could be a possible cause of the pain? And perhaps finding a less drastic solution for it than an operation!
So often people come to my practice who have had surgery for neck, back, shoulder or hip but which has completely not resolved the pain. Do you really want to go through that process (with risks) first and then not be any step further? An operation that is probably unnecessary?
Okay, but what CAN I do with the X-ray or MRI result if I have chronic pain?
In any case, it is always good and important to have a thorough examination to make sure that there is no physical cause for your pain. As indicated above, for example in case of nerves being compressed with paralysis as a result or, for example, to exclude a tumor.
But if these serious matters do not come out of the MRI as a result (fortunately!) Then I would not do so much with the results and certainly not just choose surgery immediately!
So don’t be fooled and keep your head in the game! Think logically, open yourself up to other options and do not immediately accept everything, do your own research and base your choices on it!