The CORA Connection

by Brandon Burns

How many people reading this have, or have had, low back pain? I’ll tell you what the research says. Approximately 80%. While that number may seem high to you, in my nearly 10 years of clinical practice, I would have to agree. Low back pain is one of the more common conditions that I see walk through the door of my clinic. Of those patients who seek physical therapy for low back pain, some of the most common diagnoses I see are degenerative disc disease and bulging discs. (More on those later.)

I could go on and on about the types of low back pain, how I treat them and why physical therapy is the answer. But instead, I am going to ask another question: Of that 80%, how many have had an x-ray or MRI taken to try to diagnose the cause of their back pain?

While I don’t know the exact answer to that question, I know that it is a lot. Nearly everyone has had one by the time they get to me. This x-ray or MRI is usually showing some “abnormality” that is causing their pain. Often times what is seen is described as a “disease,” “degeneration,” “abnormal” or some other medical term that is at best confusing and at worst frightening. So before you start scouring the internet for answers, which may scare you even

more, hear me out. You have to understand one thing. You are not your MRI…or x-ray, for that matter. Don’t let these images fool you. Why shouldn’t you let your MRI dictate how healthy you think your spine is? Well, I’m glad you asked.

Did you know a lumbar (low back) MRI has over a 50% false positive rate? That means, what is seen on your MRI is correct less than half the time. That’s worse than flipping a coin. I’ll say it again. There is more than a 50% chance that what was found is NOT causing your pain. Let that sink in.

Here is one thing the researchers did to find that out. They decided to see how common these “abnormalities” are in the general population, meaning people like you and me. To take it one step further they only tested people who had NO low back pain. Essentially, they went around and asked people…do you have back pain? If the person said, “no, my back feels fine,” an MRI was performed.

You remember the two diagnoses I mentioned earlier, degenerative disc disease and disc bulge? Guess what? If you’re over the age of 50 and have NO LOW BACK PAIN, there is an 80% chance that you will have a degenerative disc, and a 60% chance that you’ll have a disc bulge.

So what does this mean? These MRI findings are not abnormal. They are normal. This is part of the normal aging process. The structures of our bodies change over time, and yours is not the same as it was when it was 13. It’s no different than getting wrinkles. People without pain walk around with these “abnormalities” every day, and don’t even know it.

So you’re probably asking yourself, if it’s “normal” then why do I hurt? Well, the good news is you don’t have to. Sometimes these conditions are painful, but still very treatable. And there are options, other than pain medication and surgery, available. Physical therapy is one of those options.