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Many People Have Low Back Disc Herniations and Don’t Have Symptoms!!!

There have been many studies on this topic, one in particular in the American Journal of Neuroradiology.  The study saw that even in 20-year olds, anywhere from 20-40% of those individuals have some sort of disc pathology, but are completely symptom-free.  Every decade of life a larger percentage of that age population appears to have some sort of disc pathology (seen in MRI).  At age 50, as much as 80% of people have disk degeneration.  But what does this mean if these people don’t have symptoms???  It most likely means that is a normal part of the aging process.  Also, if a person does indeed suffer from low back pain and an MRI shows disc pathology, this doesn’t automatically mean that that particular disc is contributing to the person’s back pain.  The article summarizes by stating the results of the study strongly suggest that when degenerative findings are incidentally seen (in an MRI or X-Ray), the findings should in that case be considered as normal age-related changes rather than pathological.

Clinically, I get asked all the time how I treat low back pain….or how I treat a herniated disk.  This question is also accompanied with the patient’s MRI or X-Ray report showing some sort of disc pathology.  I like to have the patient understand that I can’t treat the image…and until I do a full mechanical and functional assessment, I can’t assume the findings in the image are causing the patient’s symptoms.  Once the assessment has taken place, I can then assume the best course of treatment for each individual patient based upon the mechanical and functional problems observed.  This is the key to successful treatment of back and/or neck pain.

 

American Journal of Neurology. 36:811-816.  April 2015.

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