There is an old saying in medicine “the difference between pathology and pain is the patient”. In our Boulder Physical Therapy and Lafayette Physical Therapy clinics this is shown in the interpretation of MRI results. As these images have become more and more sensitive they rarely miss anything in the body, but often find pathology that may not be associated with a patient’s symptoms. In addition, many of the findings in the shoulder including bone spurs, labral tears, arthritis, tendinitis, tendinopathy, and rotator cuff tears can be found in high amounts in patients without symptoms. A recent study demonstrated how prevalent these findings can be in the uninvolved shoulder of patients with shoulder pain.

Yoon and colleagues published their MRI study on patients with shoulder pain in the journal Arthroscopy: The Journal of Arthroscopic and Related Surgery (2023). Authors aimed to determine the prevalence of positive MRI findings in the involved and uninvolved sides of patients with shoulder pain. They studied 428 patients and reported when they found rotator cuff tears on the affected side they found either an single tendon or multiple tendon tear, 64% and 68% of the time, respectively. As expected, when the opposite side was symptomatic there was a higher prevalence of tears (75%), but over half of asymptomatic shoulders also had a rotator cuff tear. The concluded 2/3 of patients had a similar tear in the opposite side.

As the saying goes, the expression of symptoms from pathology in the musculoskeletal system depends significantly on the patient. Including their age, activity level, mobility, strength, and medical history.