I treat people with back pain daily. Most people that I see with back pain develop pain for no specific reason. They could be out playing with their grandchildren one day and the next morning they can hardly get out of bed. For many this can be very scary and the fist thought is to go to the ER. In some cases the physician will order an x-ray even though it's likely not necessary. An x-ray of the lumbar spine should only be used if the patient meets certain criteria. Despite this, you get an x-ray and the doctor explains that the good news is that nothing is broken. However, they explain to you other findings such as a degenerative disc or a slight scoliosis. This sounds awful to someone who doesn't have a medical background. Many are led to believe that this is the cause of their current pain. But lets think about this. You had no pain before you woke up with the pain on the weekend. So how could you have been pain-free if you have a degenerating disc and a back that's not perfectly straight? That's because these are normal findings on an x-ray. Most of the population with no back pain will have these findings. In fact, studies show that of people 50 and over with no back pain, 60% have disc bulging and 80% have disc degeneration (Brinjijkji et al, 2014). Remember, these people had no pain!
Another aspect of imaging that is not often explained is the exposure to radiation. A study by Jarvik and Deyo in 2010 showed that lumbar spine x-ray accounts for one of the highest radiation doses to the reproductive organs of a human being and is equivalent to about 65 times the dose for a chest x-ray. Why expose yourself to radiation if you don't need the test to begin with?
In fact, it's very difficult to determine the exact source of your pain despite all of the advanced imaging that exists. That' s because the lumbar spine is very complex and involves many different structures all working together. The logical explanation for you're pain is that you have a piece of tissue that's sensitive in your back. It is nearly impossible to identify the piece of tissue that is irritated since the lumbo-pelvic region is so complex. That's why it's called non-specific LBP and it's normal. And what's even better is that this gets better for most people over time. The key is to not panic and to keep moving as best you can. Don't lay in bed. Take an active approach but rest as needed.
So don't worry about these awful sounding findings on your x-ray. Remember, just like we get grey hair and wrinkles on the outside, we get them on the inside on our spines. It's a normal part of living. The worst thing you can do is to let it stop you from living your life.
Rob Willcott Physiotherapist
Rob is a physiotherapist and owner of Advantage Physiotherapy. He is part of a great team that is committed to helping people in pain.
They are located at 102 Main St. Next to the Bell Aliant store. Visit www.advantage-physio.ca for more info.
Brinjikji et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am. L. Neuroradiol. 2015 Apr;36(4):811-6
Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Annals of internal medicine. 2002 Oct 1;137(7):586–597.