Can an MRI tell you what’s wrong with your spine? Not entirely

Dr. Garima Anandani, 5 years ago

Today, the most widely used tool for diagnosis of back pain is MRI and X-rays. But the diagnosis of low back pain is much trickier because the causes could depend on many factors.

What is MRI useful for?

• Inflammatory back pain
• Severe progressive neurological deficit
• Sub-acute or chronic low back pain not responding to conservative management
• Suspected of any serious pathology

Quick Facts:

1. Not all times, findings of MRI and X-rays correlate to clinical symptoms: For example, in a study published in the journal “Annals of Internal Medicine”, authors Jeffrey G. et al, found 81% of asymptomatic individuals with a bulging disk in their MRI. Thus, an MRI should not be ordered to evaluate for the presence of a herniated disk as an initial step in the diagnosis as often it may not be the cause of pain. The findings should always be interpreted with consideration of clinical signs and symptoms and other relevant backgrounds. 2. Not a functional diagnostic measure: Mostly, there are complaints of pain in functional positions such as bending, sitting and /or standing for long hours, amongst others. The correlation between the findings and clinical symptoms become all the more important as the image is taken in a static position and not while the patient is in motion.

Relevant anatomy

The spine is comprised of four components: the vertebrae, intervertebral discs, nerves and soft tissue i.e. muscles. While MRI and X-Rays are very helpful in visualising the structures, they are less helpful to reveal a muscular picture. In almost 85% of the cases of back pain, the root cause is muscular and not structural.

Why is DSA?

Digital Spinal Analysis being a functional isometric test, gives a comprehensive analysis of the efficiencies of the spinal muscles. It helps to evaluate the strength, mobility, and balance of the muscular components of the spine by isolating the particular muscle. The reports become imperative in that it helps the clinician to accurately plan a treatment program that targets the inefficiencies and imbalances.