Hurt? Why it's usually better to not have an MRI


Without even getting into the exorbitant cost burden of unneccessary tests, here's a few reasons why getting an MRI could make you worse. 

*This advice mainly applies to active individuals dealing with joint/muscle pain from a known injury or provocation of an old injury, and it is not meant to be taken as concrete fact in every case. If you are not sure of the cause of your pain, please make an appointment with a healthcare professional.*

1. Tissue damage IS NOT why it hurts

Pain is multifactorial and complex. But tissue damage occurs in everyone as we age and get injured, and it's often very poorly linked with the cause of pain. 52% of people over age 50 without any pain have a positive finding of a herniated disc when given an MRI. Another study shows 70% percent of hockey players without any pain have abnormal MRI results of thier hips. In yet another study of patients without symptoms that had labral tears on imaging, almost half of the people responded that they thought they should have surgery to "fix" the tear! Our culture has created a prevailing and scary notion that if something is torn, we have to slice into it to repair it. Nevermind that the body can handle these tissue abnormalities and function fully with them -- but are we missing the fact that surgery creates even more tissue damage?! If we are trying to "fix" the tissue damage, howcome we are making more?

2. Psychological Impact

Here's a real MRI from a patient I treated. Despite how much was "wrong" on MRI, he was able to be make a complete recovery.

1. diffuse partial tearing of ACL
2. radial tear with fragmentation through the posterior medial meniscus
3. vertical tearing and resorption of inner third medial meniscus
4. full-thickness cartilage wear medial compartment, thinning in lateral compartment, partial and full-thickness is patellofemoral compartment
5. oblique tearing in posterior horn of lateral meniscus
6. cartilage thinning and inner-edge tearing lateral meniscus
7. joint effusion (fluid) and 4-5 cm popliteal cyst

If you had received these results, what would that do for your mental state regarding your injury? For many people, they feel more hopeless and therefore take longer to break the pain/limited movement cycle and get back into their normal exercise routine again.

3. Time

Dealing with scheduling the MRI, getting insurance approval, and waiting at the office may not be worth your time. Some physicians will even advocate for holding off on physical therapy until the results of the MRI are back. This could take up to 3 weeks in some cases, when in those 3 weeks you could have already been well on your way to returning to your usual activity. I've had patients that I began treating and getting better, who later saw an MD in order for insurance to cover treatment, and despite me communicating that they were improving, were told to get an MRI before returning to therapy. The time spent waiting for that only served to worsen the condition, which then led to a longer recovery.

If you've been waiting or debating getting an MRI, and it's weighing on you, know that there are better options. A qualified physical therapist that takes the time to talk to you and examine your problem to find the cause of the issue, without so much focus on tissue damage, is often the fastest route to recovery. And, often the best at deciding if your syptoms are coming from a non-orthopedic issue, where further imaging may in fact be necessary.