Does Your MRI Really Explain Your Lower Back Pain?

lower back pain doctor


It is generally agreed upon that there are three common causes of lower back pain. Before we dive into those three, we acknowledge that things like kidney stones, compression fractures, and muscle strains are also sources of low back pain. But for the purposes of this article, we are going to focus on the top three most common causes of low back pain.

Bulging Disc

A bulging disc occurs when the disc material oozes out of place and makes contact with the adjacent nerve. Bulging discs wreak havoc on your back and are very painful. If the disc touches the nerve you can experience pain, numbness, and tingling that travels down the back of the leg. The interesting thing here is that the disc does not have to actually touch the nerve in order to be a pain generator. An MRI is required to detect a bulging disc as these are not normally found on a plain x-ray.

Degenerative Disc Disease

The second common cause of lower back pain is related to disc degeneration. As you age your discs start to degenerate, or collapse. This creates a cascade of other problems such as arthritis and stenosis. Both of these conditions are easily found on x-rays as the height of the disc can be appreciated on the film.

Sacroiliac Joint Dysfunction

The sacroiliac joint, or SI joint, is the third common cause of lower back pain. At the bottom of the spine lies the sacrum. The sacrum sits inside the pelvis (medically referred to as the ilium) and forms the SI joint. SI joint dysfunction does not appear on imaging studies. To correctly diagnose SI joint dysfunction a physical exam is required. When you have SI joint dysfunction you can have pain that wraps around the groin or go down the leg. The SI joint is often overlooked as a source of low back pain. If it’s not seen, then it’s often ignored and not treated. Advanced training is required to properly treat SI joint dysfunction.

Most Physicians Recommend Physical Therapy FIRST

Studies have shown that 50% of the people in their 40’s will have a disc bulge on their MRI. Even worse, 70% of people in their 60’s will have a disc bulge. This study was performed on people who did not have any pain. Yes, you read that correctly, people who are pain free have a host of abnormal findings on their MRI. How can that be?

The same research has discovered that 80% of the people in their 50’s will have degenerative disc disease. At age 70, 93% of people are diagnosed with degenerative disc disease. It makes you ask, if my back stops hurting, do I no longer have disc degeneration? No, you still have degenerative disc but that problem is not your pain generator. In fact, abnormal findings on x-rays and MRI’s are a normal part of aging and may have nothing to do with why your back is actually hurting. So, what do you do when you get a diagnosis? Most physicians recommend Physical Therapy first, so why not start here? You do not need a referral to get started with Physical Therapy!

The Spine Specialists at Johns Creek Physical Therapy can help you get to the actual root cause of your pain. Our pledge is to be personally invested in helping you achieve your goals. Last year Johns Creek Physical Therapy was recognized by Appen Media as The Best Physical Therapy Practice in North Atlanta. We invite you to call our office and schedule a consultation today. Be sure to check out our reviews on our website, on Google, or come see for yourself and experience “The way therapy should be!

Office: 770-622-5344

4060 Johns Creek Parkway, Suite H

Suwanee, GA 30024