Is a picture really worth 1000 words?

As our technology continues to improve MRI and CT scanners have become more proficient at finding changes in our spines. This higher imaging quality comes with a cost in that many of these positive findings like “bulging discs”, arthritis, “pinched nerves” and the frightening-sounding “degenerative disc disease” can be found in people without symptoms. These changes can be found in up to 37% of people in their 20’s and up to 96% of people in their 80’s (Brinjikji et al. 2014). It appears many of these changes occur with the aging process similar to wrinkles appearing in our skin. An interesting study this year demonstrated that many of these findings in the lumbar spine demonstrate spontaneous regression (up to 96% of cases) even for the most severe categories of disc injury (Chiu et al. 2015).

Take home message? Keep the image in perspective given the high rate of these findings in people without pain and rely more on your symptoms and examination findings to guide your treatment decisions.