new MRI study

Hi all!

I was linked to this new study through the Pain Science blog, another great piece of evidence showing almost total lack of correlation of new MRI findings with new complaints of sciatica. Enjoy, science minded folks!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024651/ (Longitudinal associations between incident lumbar spine MRI findings and chronic low back pain or radicular symptoms: retrospective analysis of data from the longitudinal assessment of imaging and disability of the back (LAIDBACK))

 

I was able to extract the idea that MRI findings do not correlate well with symptoms... However, not having any professional or clinical backround, the article was a bit overwhelming to me.
I wonder if anyone could provide their take on key points of info in this study? I find myself ruminating... and my TMS is always activated when I get my hands on any medical research and overthink it!!
My thanks to anyone who is kind enough to respond! (I found that my symptoms did indeed got much more pronounced after getting my MRI "structure diagnosis".. MRIs are scary unless they come back perfectly clean, though the nurse at my dr told me no one after 20 has a text book spine...

 

Basically it said that in 123 people there was poor correlation with incidence of new back pain or sciatica to new MRI findings. Lots of people had new symptoms and no new findings.

A few people had new symptoms and new MRI findings but this makes sense, for example, if you had a new injury you might get some back pain or sciatica for a short time. I believe this is what happened to me- my MRI showed "disc extrusion and nerve compression" which had probably gave me my symptoms when they first occurred for a few weeks...but past that it was TMS all the way down. I'm living proof of that as I don't get any sciatica or really any back pain either at this point

Recall that no one who isn't a teenager (and even some teenagers) have perfect MRIs. Our bodies just don't work that way.

 

Hi Mindbody PT..
Thanks so much for the layman's explanation... Did I understand the study correctly where it stated that it followed the participants over a three year period and redid their MRIs? Were there any case studies whose imaging changed and correlated with symptom onset?
My MRI is two years old and I'm wondering if I should pursue a second one or keep faithful to the TMS strategies? For instance I have that borderline spinal stenosis (central) ...that keeps me afraid.. I wonder if it could've progressed in 2 yrs? My understanding is that spinal stenosis is a very slow progression and in some cases doesn't progress at all. It's the level just above my surgery, so I can't help but think it's due to that procedure and has probably been there for a very long time.. (surgery was in 1995)...thanks again for your wisdom!

 

Keep pursuing TMS strategy and don't worry about more MRIs. Didn't mean to freak anyone out with the study, its actually great evidence for TMS!

Yes of course there were a few people whose imaging changed and they had an "incidence" of symptoms but please don't think this applies to you or is even clinically relevant. The number of participants who had this was very small, and there were many more who had sciatica and no MRI changes. It might have just been happenstance that people with new disc herniations etc also had sciatica, or lasted a short period of time as often happens with an acute/new issue. The results were not statistically significant. I've had plenty of clients with spinal canal spinal stenosis who never had sciatica.